Basun H, Fratiglioni L, Winblad B
Karolinska Institute, Department of Geriatric Medicine, Huddinge University Hospital, Sweden.
J Am Geriatr Soc. 1994 Feb;42(2):132-6. doi: 10.1111/j.1532-5415.1994.tb04939.x.
To determine whether there is a relationship between serum cobalamin levels, normal aging, and Alzheimer's Disease (AD).
Cross-sectional survey.
A district (Kungsholmen) in Stockholm, Sweden.
Population-based cohort of 545 subjects aged more than 74 years. The sample was selected on the basis of evidence of cognitive impairment from all inhabitants in an area of Stockholm (2368 individuals), both living at home or in institutions.
Serum cobalamin levels and diagnostic evaluation for a diagnosis of dementia and type of dementia.
The serum cobalamin levels in non-demented individuals decreased 5.5 pmol/L with an increase of 1 year of age (regression coefficient = -5.53; P < 0.0001). However, the regression coefficient was 0.21 (P = 0.91) in demented people and 2.57 (P = 0.32) in AD subjects. There was no difference between serum cobalamin levels in demented, AD, and non-demented subjects, except for the oldest ages where demented people and AD sufferers showed higher values. AD patients still living in their own homes had significantly lower cobalamin concentrations compared with institutionalized AD sufferers. The prevalence rate of cobalamin deficiency was 15.5% (95% CI = 11.5-19.5) in normal aging and 18.1% (95% CI = 10.3-25.9) in AD.
These data suggest that serum cobalamin levels decrease in normal aging, but not in dementia or AD. A lower cobalamin concentration observed in AD sufferers still living in their own homes compared with institutionalized persons with AD seemed to be related to but not fully explained by eating habits. Patients with AD living in their own homes are at risk of developing cobalamin deficiency, and monitoring of serum cobalamin concentrations might be useful in this group.
确定血清钴胺素水平与正常衰老及阿尔茨海默病（AD）之间是否存在关联。
横断面调查。
瑞典斯德哥尔摩的一个区（ Kungsholmen）。
基于人群的545名年龄超过74岁的受试者队列。该样本是根据斯德哥尔摩一个地区（2368人）所有居民的认知障碍证据选取的，这些居民均居住在家中或机构中。
血清钴胺素水平以及痴呆诊断和痴呆类型的诊断评估。
非痴呆个体的血清钴胺素水平随着年龄每增加1岁而降低5.5 pmol/L（回归系数=-5.53；P<0.0001）。然而，痴呆患者的回归系数为0.21（P=0.91），AD受试者的回归系数为2.57（P=0.32）。痴呆、AD和非痴呆受试者的血清钴胺素水平之间没有差异，只是在最年长的年龄段，痴呆患者和AD患者的血清钴胺素水平较高。与住在机构中的AD患者相比，仍住在自己家中的AD患者的钴胺素浓度显著较低。正常衰老人群中钴胺素缺乏的患病率为15.5%（95%CI=11.5-19.5），AD患者中为18.1%（95%CI=10.3-25.9）。
这些数据表明，血清钴胺素水平在正常衰老过程中会降低，但在痴呆或AD患者中不会降低。与住在机构中的AD患者相比，仍住在自己家中的AD患者中观察到的较低钴胺素浓度似乎与饮食习惯有关，但不能完全用饮食习惯来解释。住在自己家中的AD患者有发生钴胺素缺乏的风险，监测该组患者的血清钴胺素浓度可能会有所帮助。
