Effects of micronutrients supplementation on plasma homocysteine level and global cognitive function among older adults in long-term care facilities: a randomized controlled study

Q4 Nursing

中华临床营养杂志 Pub Date : 2019-10-30 DOI:10.3760/CMA.J.ISSN.1674-635X.2019.05.001

Min Zhao, Zhuo Li, Zhuming Jiang, W. Kang, Kang Yu, Q. Lu, Xiaoxi Li, Xianna Zhang, Hai Fang, Yang Wang, Wei Li, Shenggao Han, R. Jing, Zhenshu Li, Dali Sun, Bin Zhao

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Abstract

Objective To investigate the effects of micronutrient supplementation for the elderly on plasma homocysteine level and cognitive function in institutional older adults. Methods A total of 98 older adults with the score≤11 by mini nutritional assessment short-form aged 65-100 years were enrolled and assigned to either intervention group or control group (n=49 each), with either a package of micronutrient pack or placebo daily, for three months. Fasting blood samples were collected both at baseline and the end of study to detect serum vitamin B12, folate and plasma homocysteine (Hcy) concentrations. Global cognitive function was assessed using the mini-mental state examination (MMSE). The paired t test was used to compare the continuous variables between the two groups after intervention. The relationship between changes in MMSE score and changes in plasma Hcy concentrations was examined by least-squares linear regression. Results Eighty-two patients completed the study, and 17 patients withdrew from the study due to diarrhea and hospital discharge with the drop rate of 17.3%. Compared to the control group, concentrations of serum vitamin B12 (128.8±34.8 vs 13.3±16.0 pmol/L, P=0.003) and folate (21.1±1.6 vs 0.6±0.5 nmol/L, P<0.01) significantly increased in the intervention group over 3-month supplementation, while plasma Hcy levels were remarkably reduced (-5.3±0.7 vs 1.7±0.3 μmol/L, P<0.01). The incidences of deficiency of folate, deficiency of serum vitamin B12and high Hcy all decreased in intervention group. Although individual item scores in MMSE were not changed markedly, change of total MMSE score in intervention group were higher than that in the control group (1.2±3.0 vs -0.2±2.5, P<0.05). Conclusions The supplementation of the micronutrient pack in long-term care facilities can reduce the incidence of hyperhomocysteinemia, and improve the total MMSE score. Key words: Micronutrient; Older adults; Homocysteine; Cognitive function

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补充微量营养素对长期护理机构中老年人血浆同型半胱氨酸水平和整体认知功能的影响：一项随机对照研究

目的探讨老年人补充微量营养素对住院老年人血浆同型半胱氨酸水平和认知功能的影响。方法将98名年龄在65-100岁的老年人纳入干预组或对照组（每组49人），每天服用一包微量营养素包或安慰剂，为期三个月。在基线和研究结束时采集空腹血样，以检测血清维生素B12、叶酸和血浆同型半胱氨酸（Hcy）浓度。使用简易精神状态检查（MMSE）评估整体认知功能。配对t检验用于比较干预后两组之间的连续变量。MMSE评分的变化与血浆Hcy浓度的变化之间的关系通过最小二乘线性回归进行检验。结果82例患者完成了研究，17例患者因腹泻和出院退出研究，下降率为17.3%。与对照组相比，干预组的血清维生素B12浓度（128.8±34.8 vs 13.3±16.0 pmol/L，P=0.003）和叶酸浓度（21.1±1.6 vs 0.6±0.5 nmol/L，P<0.01）在补充3个月后显著升高，干预组血浆Hcy水平显著降低（-5.3±0.7 vs 1.7±0.3μmol/L，P<0.01）。虽然MMSE单项评分变化不大，但干预组MMSE总分变化明显高于对照组（1.2±3.0 vs-0.2±2.5，P<0.05）。结论长期护理机构补充微量营养素包可降低高同型半胱氨酸血症的发生率，提高MMSE总分。关键词：微量营养素；老年人；同型半胱氨酸；认知功能

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来源期刊

中华临床营养杂志 Nursing-Nutrition and Dietetics

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0.20

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0.00%

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2282

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