摘要
尽管补充维生素B对认知功能有重要作用,确切的疗效尚不清楚。本研究的目的是系统评价并定量地综合维生素B补充治疗在减缓MCI和AD病人的认知、行为、功能性和整体衰退速度方面的疗效。在PubMed、EMBASE、国际药学文摘、临床实验上进行系统的文献检索。从2014年4月开始从政府部门、Cochrane对照试验注册库、Cochrane系统评价的数据库、Cochrane认知改善小组进行专门的登记,没有时间限制。五项试验符合申请资格,并入选Meta分析。Meta分析显示维生素B补充剂对MCI患者记忆(SMD 0.60, 95% CI 0.20, 1.000)有中等的有益作用,而对一般的认知功能(WMD -0.10, 95% CI -0.80, 0.59),执行功能(SMD 0.05, 95% CI -0.11, 0.21)和注意力(WMD -0.03, 95% CI -1.20, 1.14)无显著差异。 此外,阿尔茨海默病评估量表 (ADAS-cog) (WMD 1.01, 95% CI -0.68, 2.70)和简易精神状态检查 (MMSE) (WMD -0.22, 95% CI -1.00, 0.57)无显著性差异,在AD患者中观察到功能 (SMD 0.13, 95% CI -0.05, 0.31),行为(SMD 0.04, 95% CI -0.16, 0.25) 或整体(WMD 0.07, 95% CI -0.48, 0.62)的改变。总的来说,在MCI患者身上观察到的对记忆领域有益的证据很少。尽管如此,未来仍需要标准的随机对照试验来确定是否在更广泛的人群有显著性。但是,这些数据还不能为维生素B对MCI患者一般认知功能、执行功能和注意力有效提供充分的证据。类似地,单独叶酸或维生素B的组合是不能稳定或延缓认知、功能、行为的衰退和AD患者的整体变化。
关键词: 阿尔茨海默病,叶酸,meta分析,轻度认知障碍,维生素B,维生素B6,维生素B12
Current Alzheimer Research
Title:Efficacy of Vitamins B Supplementation on Mild Cognitive Impairment and Alzheimer`s Disease: A Systematic Review and Meta-Analysis
Volume: 11 Issue: 9
Author(s): Meng-Meng Li, Jin-Tai Yu, Hui-Fu Wang, Teng Jiang, Jun Wang, Xiang-Fei Meng, Chen-Chen Tan, Chong Wang and Lan Tan
Affiliation:
关键词: 阿尔茨海默病,叶酸,meta分析,轻度认知障碍,维生素B,维生素B6,维生素B12
摘要: Despite B vitamin supplementation playing an important role in cognitive function, the exact effect remains unknown. The aim of this study was to systematically review and quantitatively synthesize the efficacy of treatment with vitamins B supplementation in slowing the rate of cognitive, behavioral, functional and global decline in individuals with MCI or AD. A systematic literature search in PubMed, EMBASE, International Pharmaceutical Abstracts, clinicaltrials. gov, the Cochrane Controlled Trials Register, the Cochrane Database of Systematic Reviews, and the Cochrane Cognitive Improvement Group specialized registry was conducted on April 2014, with no limit of date. Five trials met the eligibility criteria and were selected for this meta-analysis. Meta-analysis showed moderate beneficial effects of vitamins B supplementation on memory (SMD 0.60, 95% CI 0.20, 1.00), whereas no significant difference on general cognitive function (WMD -0.10, 95% CI -0.80, 0.59), executive function (SMD 0.05, 95% CI -0.11, 0.21) and attention (WMD -0.03, 95% CI -1.20, 1.14) were found in MCI patients. In addition, no significantly cognitive benefits on the Alzheimer’s Disease Assessment Scale (ADAS-cog) (WMD 1.01, 95% CI -0.68, 2.70) and Mini Mental State Examination (MMSE) (WMD -0.22, 95% CI -1.00, 0.57), functional (SMD 0.13, 95% CI -0.05, 0.31), behavioral (SMD 0.04, 95% CI -0.16, 0.25) or global (WMD 0.07, 95% CI -0.48, 0.62) change were observed in AD patients. Collectively, weak evidence of benefits was observed for the domains of memory in patients with MCI. Nevertheless, future standard RCTs are still needed to determine whether it was still significant in larger populations. However, the data does not yet provide adequate evidence of an effect of vitamins B on general cognitive function, executive function and attention in people with MCI. Similarly, folic acid alone or vitamins B in combination are unable to stabilize or slow decline in cognition, function, behavior, and global change of AD patients.
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Li Meng-Meng, Yu Jin-Tai, Wang Hui-Fu, Jiang Teng, Wang Jun, Meng Xiang-Fei, Tan Chen-Chen, Wang Chong and Tan Lan, Efficacy of Vitamins B Supplementation on Mild Cognitive Impairment and Alzheimer`s Disease: A Systematic Review and Meta-Analysis, Current Alzheimer Research 2014; 11 (9) . https://dx.doi.org/10.2174/1567205011666141001114140
DOI https://dx.doi.org/10.2174/1567205011666141001114140 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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