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叶酸补充对轻度认知障碍老年患者认知功能和炎症的影响:系统评价和随机对照试验的荟萃分析。

Effects of folic acid supplementation on cognitive function and inflammation in elderly patients with mild cognitive impairment: A systematic review and meta-analysis of randomized controlled trials.

机构信息

Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, China.

Xiangya Hospital, Central South University, Changsha, China.

出版信息

Arch Gerontol Geriatr. 2024 Nov;126:105540. doi: 10.1016/j.archger.2024.105540. Epub 2024 Jun 19.

DOI:10.1016/j.archger.2024.105540
PMID:38964091
Abstract

OBJECT

The aim was to assess the effect of folic acid supplementation on cognitive function and inflammatory cytokines in elderly patients with mild cognitive impairment.

METHODS

From its inception until February 2024, four databases including Web of Science were searched. Two researchers independently screened the literature, assessed the quality, extracted data, and conducted a meta-analysis using RevMan.

RESULTS

The systematic review included seven studies (with a total of 1102 participants, mean age 65-80 years), seven of which were appropriate for meta-analysis. Although a small number of studies found relatively large heterogeneity, the majority of studies showed significant benefit from folic acid supplementation, including the FSIQ (823 individuals, standardized mean difference [SMD] = 8.36, 95 % confidence interval [CI] = 0.79 - 1.08), Arithmetic (823 individuals, SMD = 0.17, 95 % CI = -0.03-0.31), Information, SMD = 1.73, 95 % CI 0.41-3.05), Digit Span (823 individuals, SMD = 0.17, 95 % CI = -0.03 - 0.31), Block Design (823 individuals, SMD = 0.26, 95 % CI 0.03-0.49), Picture Completion (823 individuals, SMD = 0.27, 95 % CI = -0.15 - 0.69) and Picture Arrangement (823 individuals, SMD = -0.12, 95 % CI = -0.26 - 0.01). Finally, folic acid supplementation had a significant effect on the reduction of most inflammatory cytokines, blood biomarkers of Alzheimer's disease, and Hcy.

CONCLUSIONS

Folic acid supplementation seems to have a positive impact on cognitive function in older adults with mild cognitive impairment, but further evidence of its effectiveness in improving inflammatory cytokines is needed from high-quality studies.

摘要

目的

评估叶酸补充对轻度认知障碍老年患者认知功能和炎症细胞因子的影响。

方法

从创建到 2024 年 2 月,我们在 Web of Science 等四个数据库中进行了检索。两位研究人员独立筛选文献、评估质量、提取数据,并使用 RevMan 进行荟萃分析。

结果

系统评价纳入了 7 项研究(共 1102 名参与者,平均年龄 65-80 岁),其中 7 项研究适合进行荟萃分析。尽管少数研究发现存在较大的异质性,但大多数研究表明叶酸补充具有显著的益处,包括 FSIQ(823 人,标准化均数差 [SMD] = 8.36,95%置信区间 [CI] = 0.79-1.08)、算术(823 人,SMD = 0.17,95%CI = -0.03-0.31)、信息,SMD = 1.73,95%CI 0.41-3.05)、数字跨度(823 人,SMD = 0.17,95%CI = -0.03-0.31)、积木设计(823 人,SMD = 0.26,95%CI = 0.03-0.49)、图片完成(823 人,SMD = 0.27,95%CI = -0.15-0.69)和图片排列(823 人,SMD = -0.12,95%CI = -0.26-0.01)。最后,叶酸补充对降低大多数炎症细胞因子、阿尔茨海默病的血液生物标志物和 Hcy 具有显著作用。

结论

叶酸补充似乎对轻度认知障碍老年患者的认知功能有积极影响,但需要高质量研究进一步证明其改善炎症细胞因子的有效性。

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