Liao Yingqi, Zhang Haoran, Zhang Yaping, Kan Cheuk Ni, Chia Rachel Sher Li, Chai Yuek Ling, Cheng Ching-Yu, Chen Christopher, Xu Xin
Memory, Aging and Cognition Centre, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
School of Public Health and the Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China.
Clin Nutr. 2025 Jan;44:25-32. doi: 10.1016/j.clnu.2024.11.037. Epub 2024 Nov 24.
Vitamin B12 deficiency has been associated with neuropsychiatric symptoms (NPS), but the relationship between vitamin B12 and NPS remains unclear prior to the onset of dementia. The study aims to examine the association between vitamin B12 and NPS in dementia-free Asian older adults.
This is a cross-sectional population-based study where multi-ethnic community-dwelling Asian participants (i.e. Chinese, Malay, Indian) aged ≥60 years underwent comprehensive neuropsychological and clinical assessments including the examination of clinical history and the collection of blood samples. NPS and subsyndromes were evaluated using the Neuropsychiatric Inventory (NPI). Serum vitamin B12 and homocysteine (Hcy) concentration were measured by competitive immunoassays. To analyse the relationship between vitamin B12 and NPS, hierarchical linear regression, multinomial regression and moderation analyses were performed.
A total of 798 dementia-free individuals (age = 69.7 ± 6.5 years old, F = 408 (51.1 %)) were included in the current study. There were 80 (10 %) individuals with clinically relevant NPS (i.e. NPI scores ≥4). Higher vitamin B12 was associated with lower NPI total scores (p = 0.030) and apathy (p = 0.005), after controlling for age, sex, ethnicity, cognitive functioning, socioeconomic status and Hcy concentration. Participants with higher vitamin B12 was also less likely to have clinically relevant apathy (p = 0.007). The moderation effect of Hcy and cognitive functioning on the inverse association between vitamin B12 and NPS was observed.
A protective effect of vitamin B12 on NPS and subsyndromes was observed in a multi-ethnic Asian cohort of dementia-free individuals. Future longitudinal studies are required to further elucidate the pathophysiological mechanisms between vitamin B12 and NPS in diverse ethnic groups.
维生素B12缺乏与神经精神症状（NPS）有关，但在痴呆症发病前，维生素B12与NPS之间的关系仍不明确。本研究旨在探讨无痴呆症的亚洲老年人中维生素B12与NPS之间的关联。
这是一项基于人群的横断面研究，年龄≥60岁的多民族社区居住亚洲参与者（即华裔、马来裔、印度裔）接受了全面的神经心理学和临床评估，包括临床病史检查和血样采集。使用神经精神科问卷（NPI）评估NPS及其亚综合征。采用竞争性免疫测定法测定血清维生素B12和同型半胱氨酸（Hcy）浓度。为了分析维生素B12与NPS之间的关系，进行了分层线性回归、多项回归和调节分析。
本研究共纳入798名无痴呆症个体（年龄=69.7±6.5岁，女性=408名（51.1%））。有80名（10%）个体存在具有临床意义的NPS（即NPI评分≥4）。在控制年龄、性别、种族、认知功能、社会经济地位和Hcy浓度后，较高的维生素B12水平与较低的NPI总分（p=0.030）和淡漠（p=0.005）相关。维生素B12水平较高的参与者出现具有临床意义的淡漠的可能性也较小（p=0.007）。观察到Hcy和认知功能对维生素B12与NPS之间的负相关关系具有调节作用。
在一个多民族无痴呆症亚洲队列中，观察到维生素B12对NPS及其亚综合征具有保护作用。未来需要进行纵向研究，以进一步阐明不同种族人群中维生素B12与NPS之间的病理生理机制。
