Efficacy of B Vitamin Supplementation on Global Cognitive Function in Older Adults: A Systematic Review and Meta-analysis.

IF 4.9 2区 医学 Q1 NUTRITION & DIETETICS
Jade Berg, Ross Grant, Mario Siervo, Blossom C M Stephan, Phillip J Tully
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引用次数: 0

Abstract

Context: Elevated homocysteine levels are associated with brain atrophy and dementia, with B vitamin supplementation a possible low-cost intervention to help mitigate the deleterious impacts on brain health. However, prior meta-analyses have produced inconsistent results, with unexplained heterogeneity, while the quality of evidence has not been assessed.

Objective: This systematic review, meta-analysis, and meta-regression sought to quantify the effect of B vitamin supplementation on global cognitive function in older adults.

Data sources: PubMed, Embase, PsychInfo, Scopus, and the Cochrane Library databases were searched for randomized controlled trials (RCTs) from inception to June 20, 2024.

Data extraction: Eligible RCTs were derived from populations aged ≥60 years, with interventions of 26 weeks or longer comprising vitamin(s) B6, B9, or B12 of any dose or administration route, compared with placebo or usual dementia care. Studies must also have quantified global cognitive function at baseline and at end of treatment.

Data analysis: Seventeen RCTs, including 5275 participants, were identified. A small to moderate improvement (Hedges' g = 0.423; 95% CI: 0.188 to 0.657) in global cognitive function after supplementation was observed with considerable heterogeneity (I2 = 92.71; Grading of Recommendations, Assessment, Development, and Evaluations [GRADE] = very low certainty). A meta-regression identified that statistical outliers and single-blinded studies contributed to the pooled g and heterogeneity. Omitting these studies resulted in a small effect (g = 0.110; 95% CI: 0.034 to 0.186), with negligible heterogeneity (I2 = 15.39; GRADE = high certainty). The effect size did not differ between classifications of cognitive impairment (ie, intact cognition, mild cognitive impairment, and dementia) in subgroup analysis (P = .729).

Conclusion: The pooled findings indicated there is high-certainty evidence that vitamin B6, B9, or B12 supplementation has a very small benefit on global cognitive function in older adults.

Systematic review registration: PROSPERO registration no. CRD42024553717.

补充维生素B对老年人整体认知功能的影响:一项系统综述和荟萃分析。
背景:高同型半胱氨酸水平与脑萎缩和痴呆有关,补充维生素B可能是一种低成本的干预措施,有助于减轻对大脑健康的有害影响。然而,先前的荟萃分析产生了不一致的结果,存在无法解释的异质性,而证据的质量尚未得到评估。目的:本系统综述、荟萃分析和荟萃回归旨在量化补充维生素B对老年人整体认知功能的影响。数据来源:检索PubMed, Embase, PsychInfo, Scopus和Cochrane Library数据库,检索从初始到2024年6月20日的随机对照试验(RCTs)。数据提取:符合条件的随机对照试验来自年龄≥60岁的人群,干预时间为26周或更长,包括任何剂量或给药途径的维生素B6、B9或B12,与安慰剂或常规痴呆护理相比。研究还必须量化基线和治疗结束时的整体认知功能。数据分析:纳入17项随机对照试验,共5275名受试者。补充后整体认知功能有小到中等程度的改善(Hedges' g = 0.423; 95% CI: 0.188至0.657),但存在相当大的异质性(I2 = 92.71;推荐、评估、发展和评价评分[GRADE] =非常低的确定性)。荟萃回归发现,统计异常值和单盲研究有助于汇总g和异质性。忽略这些研究的影响较小(g = 0.110; 95% CI: 0.034 ~ 0.186),异质性可忽略不计(I2 = 15.39; GRADE =高确定性)。在亚组分析中,认知障碍分类(即完整认知、轻度认知障碍和痴呆)的效应量无差异(P = .729)。结论:综合研究结果表明,有高度肯定的证据表明,维生素B6、B9或B12补充剂对老年人的整体认知功能有非常小的益处。系统评审注册:普洛斯彼罗注册号。CRD42024553717。
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来源期刊
Nutrition reviews
Nutrition reviews 医学-营养学
CiteScore
12.20
自引率
1.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
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