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Efficacy of Vitamin B Supplementation on Cognition in Elderly Patients With Cognitive-Related Diseases.
J Geriatr Psychiatry Neurol 2017; 30(1):50-59JG

Abstract

Increase in serum homocysteine is shown to be a potential risk factor for cognitive impairment. Evidence suggests that vitamin B supplementation may reduce cognitive decline by lowering the homocysteine levels. The current meta-analysis evaluated the efficacy of folic acid along with vitamin B12 and/or B6 in lowering homocysteine, thereby attenuating cognitive decline in elderly patients with Alzheimer disease or dementia. Randomized controlled trials (RCTs) comparing the efficacy of folate and B vitamin supplementation in patients with cognitive decline secondary to Alzheimer disease or dementia were identified using the keywords, "homocysteine, hyper-homocysteinemia, B vitamin, vitamin B6, B12, folic acid, cognitive, Alzheimer's disease, and dementia." The outcome measures analyzed were the Mini-Mental State Examination (MMSE) score and serum homocysteine. Of the 77 studies identified, 4 RCTs were included in the current meta-analysis. The baseline characteristics, age, and gender distribution of patients among the 2 groups (supplement vs placebo) were comparable. The results reveal that the intervention group achieved significantly greater reduction in homocysteine levels than the control (pooled difference in means = -3.625, 95% confidence interval [CI] = -5.642 to -1.608, P < .001). However, no significant difference in MMSE (pooled difference in means = 0.027, 95% CI = -0.518 to 0.573, P = 0.921) was observed between the groups. Taken together, vitamin B supplementation was effective in reducing serum homocysteine levels. However, it did not translate into cognitive improvement, indicating that the existing data on vitamin B-induced improvement in cognition by lowering homocysteine levels are conflicting.

Authors+Show Affiliations

1 Department of Geriatrics, Fuzhou General Hospital of Nanjing Command, PLA and Clinical Medical College of Fujian Medical University, Fuzhou, China.2 Department of Neurology, Fuzhou General Hospital of Nanjing Command, PLA and Clinical Medical College of Fujian Medical University, Fuzhou, China.2 Department of Neurology, Fuzhou General Hospital of Nanjing Command, PLA and Clinical Medical College of Fujian Medical University, Fuzhou, China.2 Department of Neurology, Fuzhou General Hospital of Nanjing Command, PLA and Clinical Medical College of Fujian Medical University, Fuzhou, China.

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

28248558

Citation

Zhang, Dong-Mei, et al. "Efficacy of Vitamin B Supplementation On Cognition in Elderly Patients With Cognitive-Related Diseases." Journal of Geriatric Psychiatry and Neurology, vol. 30, no. 1, 2017, pp. 50-59.
Zhang DM, Ye JX, Mu JS, et al. Efficacy of Vitamin B Supplementation on Cognition in Elderly Patients With Cognitive-Related Diseases. J Geriatr Psychiatry Neurol. 2017;30(1):50-59.
Zhang, D. M., Ye, J. X., Mu, J. S., & Cui, X. P. (2017). Efficacy of Vitamin B Supplementation on Cognition in Elderly Patients With Cognitive-Related Diseases. Journal of Geriatric Psychiatry and Neurology, 30(1), pp. 50-59. doi:10.1177/0891988716673466.
Zhang DM, et al. Efficacy of Vitamin B Supplementation On Cognition in Elderly Patients With Cognitive-Related Diseases. J Geriatr Psychiatry Neurol. 2017;30(1):50-59. PubMed PMID: 28248558.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of Vitamin B Supplementation on Cognition in Elderly Patients With Cognitive-Related Diseases. AU - Zhang,Dong-Mei, AU - Ye,Jian-Xin, AU - Mu,Jun-Shan, AU - Cui,Xiao-Ping, Y1 - 2016/10/17/ PY - 2017/3/2/entrez PY - 2017/3/2/pubmed PY - 2017/5/4/medline KW - aged KW - cognitive disorders KW - folic acid KW - homocysteine KW - vitamin B 6 KW - vitamin B12 SP - 50 EP - 59 JF - Journal of geriatric psychiatry and neurology JO - J Geriatr Psychiatry Neurol VL - 30 IS - 1 N2 - Increase in serum homocysteine is shown to be a potential risk factor for cognitive impairment. Evidence suggests that vitamin B supplementation may reduce cognitive decline by lowering the homocysteine levels. The current meta-analysis evaluated the efficacy of folic acid along with vitamin B12 and/or B6 in lowering homocysteine, thereby attenuating cognitive decline in elderly patients with Alzheimer disease or dementia. Randomized controlled trials (RCTs) comparing the efficacy of folate and B vitamin supplementation in patients with cognitive decline secondary to Alzheimer disease or dementia were identified using the keywords, "homocysteine, hyper-homocysteinemia, B vitamin, vitamin B6, B12, folic acid, cognitive, Alzheimer's disease, and dementia." The outcome measures analyzed were the Mini-Mental State Examination (MMSE) score and serum homocysteine. Of the 77 studies identified, 4 RCTs were included in the current meta-analysis. The baseline characteristics, age, and gender distribution of patients among the 2 groups (supplement vs placebo) were comparable. The results reveal that the intervention group achieved significantly greater reduction in homocysteine levels than the control (pooled difference in means = -3.625, 95% confidence interval [CI] = -5.642 to -1.608, P < .001). However, no significant difference in MMSE (pooled difference in means = 0.027, 95% CI = -0.518 to 0.573, P = 0.921) was observed between the groups. Taken together, vitamin B supplementation was effective in reducing serum homocysteine levels. However, it did not translate into cognitive improvement, indicating that the existing data on vitamin B-induced improvement in cognition by lowering homocysteine levels are conflicting. SN - 0891-9887 UR - https://www.unboundmedicine.com/medline/citation/28248558/Efficacy_of_Vitamin_B_Supplementation_on_Cognition_in_Elderly_Patients_With_Cognitive_Related_Diseases_ L2 - http://journals.sagepub.com/doi/full/10.1177/0891988716673466?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -