Efficacy of Vitamin B Supplementation on Cognition in Elderly Patients With Cognitive-Related Diseases

2016 ◽  
Vol 30 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Dong-Mei Zhang ◽  
Jian-Xin Ye ◽  
Jun-Shan Mu ◽  
Xiao-Ping Cui
Keyword(s):  
Folic Acid ◽  
Alzheimer Disease ◽  
Elderly Patients ◽  
Cognitive Decline ◽  
Meta Analysis ◽  
Vitamin B ◽  
Cognitive Improvement ◽  
Serum Homocysteine ◽  
Significant Difference ◽  
B Vitamin

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.

scholarly journals B-vitamins and prevention of dementia

2008 ◽  
Vol 67 (1) ◽  
pp. 75-81 ◽  
Author(s):  
Robert Clarke
Keyword(s):  
Folic Acid ◽  
Cognitive Function ◽  
Meta Analysis ◽  
B Vitamins ◽  
Vitamin Supplementation ◽  
Vitamin B ◽  
Cross Sectional ◽  
Principal Investigators ◽  
Individual Participant ◽  
B Vitamin

Elevated plasma homocysteine (Hcy) concentrations have been implicated with risk of cognitive impairment and dementia, but it is unclear whether low vitamin B12 or folate status is responsible for cognitive decline. Most studies reporting associations between cognitive function and Hcy or B-vitamins have used a cross-sectional or case–control design and have been unable to exclude the possibility that such associations are a result of the disease rather than being causal. The Hcy hypothesis of dementia has attracted considerable interest, as Hcy can be easily lowered by folic acid and vitamin B12, raising the prospect that B-vitamin supplementation could lower the risk of dementia. While some trials assessing effects on cognitive function have used folic acid alone, vitamin B12 alone or a combination, few trials have included a sufficient number of participants to provide reliable evidence. An individual-patient-data meta-analysis of all randomised trials of the effects on cognitive function and vascular risk of lowering Hcy with B-vitamins will maximise the power to assess the epidemiologically-predicted differences in risk. Among the twelve large randomised Hcy-lowering trials for prevention of vascular disease, data should be available on about 30 000 participants with cognitive function. The principal investigators of such trials have agreed to combine individual-participant data from their trials after their separate publication.

Abstract 173: Effect Of B-Vitamins On Cognition In Patients With Prior Stroke

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Graeme J Hankey ◽  
Keyword(s):  
Cognitive Impairment ◽  
Folic Acid ◽  
Cognitive Decline ◽  
Mmse Score ◽  
High Serum ◽  
B Vitamins ◽  
Vitamin B ◽  
Stroke Event ◽  
Double Blind ◽  
Significant Difference

High serum total homocysteine (tHcy) and stroke are associated with increased risks of cognitive decline and cognitive impairment. This study aimed to determine whether B-vitamin treatment would reduce the risk of cognitive decline and cognitive impairment among individuals with recent stroke or transient ischemic attack (TIA) of the brain. Methods: 8,164 patients with recent stroke or TIA (< 7 months) were randomly allocated to double-blind treatment with one tablet daily of placebo or B-vitamins (folic acid 2 mg, vitamin B 6 25 mg, vitamin B 12 500 μg) and followed for a median of 3.4 years for the occurrence of stroke, myocardial infarction or death due to vascular causes in the VITAmins TO Prevent Stroke (VITATOPS) trial. The Mini-Mental State Examination (MMSE) score was undertaken at least 6 months after the qualifying stroke (baseline) and every 6 months thereafter for the duration of follow-up. The primary outcome for this pre-specified secondary analysis was the composite of a decline of 3 or more points in the MMSE score compared with the baseline score at > 6 months after the qualifying stroke (cognitive decline) or a new MMSE score < 24 (cognitive impairment). Results: Among the 2214 participants who undertook the MMSE at least 6 months after the qualifying stroke event, and who were not cognitively impaired (MMSE > 24), and who underwent repeat MMSE assessments over a median of 2.8 years, there was no significant difference in the incidence of cognitive decline or cognitive impairment among participants assigned B-vitamins compared with placebo (24.6% vs 21.7%; risk ratio [RR]: 1.13, 95% confidence interval [CI]: 0.97 to 1.32 ; p=0.1113) and no difference in cognitive decline alone (22.7% vs 20.7%; RR: 1.10, 95% CI: 0.94 to 1.19; p=0.2417). These results were consistent among clinical subgroups. From baseline (at 6 months post-stroke), the MMSE score decreased by a mean of 0.22 (SD 1.82) among participants assigned B-vitamins vs 0.25 (SD 2.08) among participants assigned placebo (p=0.7258). Conclusion: Daily administration of folic acid, vitamin B 6 and vitamin B 12 to non-demented patients with previous stroke or TIA for a median of 2.8 years had no significant effect, compared with placebo, on the rate of cognitive decline or incidence of cognitive impairment.

Serum Homocysteine, B12 and Folic Acid Concentration in Thai Overweight and Obese Subjects

2003 ◽  
Vol 73 (1) ◽  
pp. 8-14 ◽  
Author(s):  
R. Tungtrongchitr ◽  
P. Pongpaew ◽  
C. Tongboonchoo ◽  
N. Vudhivai ◽  
S. Changbumrung ◽  
...  
Keyword(s):  
Folic Acid ◽  
Vitamin C ◽  
Negative Correlation ◽  
Vitamin B ◽  
Control Subjects ◽  
Serum Homocysteine ◽  
Significant Difference ◽  
Obese Subjects ◽  
Serum Folic Acid ◽  
Overweight Subjects

This study investigated levels of serum homocysteine, vitamin B12, folic acid, vitamin B62 and vitamin C, in 37 male and 112 female overweight and obese Thai volunteers (body mass index; BMI ≥ 25.00), and 23 male and 90 female normal-weight Thai volunteers, who came for a physical check-up at the Out-patient Department, General Practice Section, Rajvithi Hospital, Bangkok from March to October of 2000. Data included anthropometric measurements and waist/hip ratios. All anthropometric variables, except height, were significantly higher for the overweight subjects than for the normal subjects. Statistically significantly higher levels of serum homocysteine were found in the overweight subjects. Serum homocysteine concentrations in overweight and obese males were significantly higher than in overweight and obese females. Serum folic acid and vitamin C in the overweight and obese were found to be statistically significantly lower than in the control subjects. No statistically significant difference in vitamin B12 was found in the overweight and obese subjects compared with the normal control subjects. The medians of serum folic acid and vitamin C concentrations for the overweight and obese males were significantly lower than those of the overweight and obese females. A negative correlation was found between serum folic acid and homocysteine concentrations in all overweight and obese subjects. A significant negative correlation between serum folic acid and vitamin B6 was observed in both male and female overweight and obese subjects. The results of the investigation suggest that homocysteine levels in overweight and obese subjects seem to be caused by insufficient dietary folic acid intake and probably not by B12 deficiency.

CAG (cytarabine, aclarubicin, G-CSF) Regimen Is Effective and Well Tolerated in 367 Elderly Patients with AML in China and Japan: A Meta-Analysis

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4290-4290
Author(s):  
Guoqing Wei ◽  
Delong Liu
Keyword(s):  
Elderly Patients ◽  
Fixed Effects ◽  
Conflicts Of Interest ◽  
Meta Analysis ◽  
Current Therapy ◽  
Newly Diagnosed ◽  
Fixed Effects Model ◽  
Elderly Aml ◽  
Significant Difference ◽  
China And Japan

Abstract Abstract 4290 Background: Current therapy is still unsatisfactory in elderly patients (pts) with acute myeloid leukemia (AML). CAG regimen (cytarabine, aclarubicin, G-CSF) has been commonly used in China and Japan for the treatment of elderly AML pts. The aim of this study is to summarize the data and to analyze the efficacy as well as the toxic effects of CAG regimen in elderly AML pts. Methods: The databases of PubMed, Wanfang Data, as well as American Society of Hematology (ASH) annual meeting abstracts were searched for articles published in English, Chinese and Japanese languages from January 1995 to December 2010. Eligible studies were relevant clinical trials of elderly AML pts treated with CAG regimen. Complete remission (CR) rate, odds ratio (OR) and 95% confidence intervals (CIs) of chemotherapy were compared through a meta-analysis using a random-effects or fixed-effects model. Results: 19 trials with a total of 367 elderly AML pts were identified and included for analysis. Among the 367 AML pts treated with CAG, 266 pts were newly diagnosed AML, 54 pts were relapsed/refractory (R/R) AML. The AML status was not specified in the rest 47 pts. The CR rate for the 367 elderly AML pts was 52.0% (95% CI 46.8%-57.2%). Interestingly, no significant difference in CR rates was noted between the newly diagnosed (54.7%, 95% CI 48.6%-60.7%) and R/R AML pts (45.7%, 95% CI 32.4%-59.6%) (Q=1.332, p=0.248). Three studies compared the CR rates of elderly AML pts according to the karyotype. The CR rate was significantly higher in pts with intermediate (72.4%, 95% CI 58.0%-83.3%) cytogenetics than those with unfavorable one (35.7%, 95% CI 18.7%-57.2%) (Q=7.803, p=0.005). These elderly AML pts tolerated CAG well with low cardiotoxicity (0.73%, 2/273) and ED (8.48%, 29/342). Conclusions: CAG regimen induced high CR rates in elderly pts with new and relapsed/ refractory AML. This regimen was well tolerated with low cardiotoxicity and early death rate. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The effect of folate fortification on folic acid-based homocysteine-lowering intervention and stroke risk: a meta-analysis

2014 ◽  
Vol 18 (8) ◽  
pp. 1514-1521 ◽  
Author(s):  
Rui Zeng ◽  
Chun-Hua Xu ◽  
Yuan-Ning Xu ◽  
Ya-Li Wang ◽  
Mian Wang
Keyword(s):  
Folic Acid ◽  
Randomized Controlled Trials ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Folic Acid Supplementation ◽  
Folate Intake ◽  
Controlled Trials ◽  
Acid Supplementation ◽  
Randomized Controlled ◽  
Significant Difference

AbstractObjectiveFolate and vitamin B12 are two vital regulators in the metabolic process of homocysteine, which is a risk factor of atherothrombotic events. Low folate intake or low plasma folate concentration is associated with increased stroke risk. Previous randomized controlled trials presented discordant findings in the effect of folic acid supplementation-based homocysteine lowering on stroke risk. The aim of the present review was to perform a meta-analysis of relevant randomized controlled trials to check the how different folate fortification status might affect the effects of folic acid supplementation in lowering homocysteine and reducing stroke risk.DesignRelevant randomized controlled trials were identified through formal literature search. Homocysteine reduction was compared in subgroups stratified by folate fortification status. Relative risks with 95 % confidence intervals were used as a measure to assess the association between folic acid supplementation and stroke risk.SettingThe meta-analysis included fourteen randomized controlled trials,SubjectsA total of 39 420 patients.ResultsHomocysteine reductions were 26·99 (sd 1·91) %, 18·38 (sd 3·82) % and 21·30 (sd 1·98) %, respectively, in the subgroups without folate fortification, with folate fortification and with partial folate fortification. Significant difference was observed between the subgroups with folate fortification and without folate fortification (P=0·05). The relative risk of stroke was 0·88 (95 % CI 0·77, 1·00, P=0·05) in the subgroup without folate fortification, 0·94 (95 % CI 0·58, 1·54, P=0·82) in the subgroup with folate fortification and 0·91 (95 % CI 0·82, 1·01, P=0·09) in the subgroup with partial folate fortification.ConclusionsFolic acid supplementation might have a modest benefit on stroke prevention in regions without folate fortification.

Homocysteine, folic acid and vitamin B12 in relation to pre- and postnatal health aspects

2005 ◽  
Vol 43 (10) ◽  
Author(s):  
Rima Obeid ◽  
Wolfgang Herrmann
Keyword(s):  
Folic Acid ◽  
Vitamin B12 ◽  
Pregnancy Outcomes ◽  
Pregnancy Complications ◽  
Plasma Homocysteine ◽  
Vitamin B ◽  
Total Plasma ◽  
Vitamin Status ◽  
B Vitamin ◽  
Early Abortion

AbstractStudies linking hyperhomocysteinemia (HHCY) and B-vitamin deficiency to some health aspects in children have been accumulating. Low B-vitamin status inearly life, even as early as the time of conception, may endanger the potential for new life and may negatively influence the health of the offspring. Early abortion, pregnancy complications and poor pregnancy outcomes have been linked to elevated concentrations of total plasma homocysteine (tHcy) and low folate or vitamin B

scholarly journals Serum homocysteine and folate concentrations among a US cohort of adolescents before and after folic acid fortification

2012 ◽  
Vol 15 (10) ◽  
pp. 1818-1826 ◽  
Author(s):  
Daniel A Enquobahrie ◽  
Henry A Feldman ◽  
Deanna H Hoelscher ◽  
Lyn M Steffen ◽  
Larry S Webber ◽  
...  
Keyword(s):  
Folic Acid ◽  
Cardiovascular Health ◽  
Serum Folate ◽  
Vitamin B ◽  
Serum Concentrations ◽  
Folic Acid Fortification ◽  
Serum Homocysteine ◽  
Cereal Grain ◽  
Before And After ◽  
Average Serum

AbstractObjectiveWe assessed serum homocysteine (tHcy) and folate concentrations among US adolescents before and after fortification of cereal-grain products with folic acid, and associations with demographic, behavioural and physiological factors.DesignObservational study conducted among participants of a randomized trial.SettingThe Child and Adolescent Trial for Cardiovascular Health (CATCH) study.SubjectsAdolescents (n2445) in grades 8 (pre-fortification, mean age 14 years) and 12 (post-fortification, mean age 18 years).ResultsAverage serum concentrations of tHcy, folate and vitamin B6increased by 17 %, 16 % and 14 %, respectively, while serum concentrations of vitamin B12decreased by 11 % post-fortification. Folic acid fortification provided, on average, an additional intake of 118 μg folate/d. Male sex (P< 0·0001) and white race (P= 0·0008) were associated with significantly greater increases in tHcy concentration, while increases in BMI (P= 0·006) and serum folate concentration (P< 0·0001) were associated with significant decreases in tHcy concentration. Female sex (P< 0·0001), non-smoking (P< 0·0001), use of multivitamins (P< 0·0001) and higher dietary intake of folate (P= 0·001) were associated with significantly greater increases in serum folate concentrations. From grade 8 to grade 12, the upward age trend in serum tHcy concentration was uninterrupted in its course (P> 0·50); whereas serum folic acid concentration showed a downward trend that incurred a discrete jump upward (17 % higher;P< 0·0001) with fortification. These trends differed significantly for malesv. females (P< 0·001 for interaction).ConclusionsFortification had a significant impact on improving folate status but not serum tHcy concentrations among US adolescents.

scholarly journals The preventive efficacy of vitamin B supplement on the cognitive decline of elderly adults: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Shufeng Li ◽  
Yuchen Guo ◽  
Jie Men ◽  
Hanlin Fu ◽  
Ting Xu
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Meta Analysis ◽  
Mean Difference ◽  
Controlled Trials ◽  
Vitamin B ◽  
Cochrane Central Register ◽  
Elderly Adults ◽  
Preventive Medication ◽  
Preventive Efficacy

Abstract Background: The irreversibility of cognitive impairment of Alzheimer’s disease (AD) prompts that preventing or delaying the onset of AD should be a public health priority. Vitamin B supplement can lower the serum homocysteine (Hcy) level, but whether it can prevent cognitive decline or not remains unclear. We aimed to evaluate the preventive efficacy of vitamin B supplement on the cognitive decline of elderly adults.Methods: We searched PubMed, Embase, The Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, Science Direct, PsycINFO from inception to December 1, 2019, and then updated the retrieved results on June 1, 2020. The randomized controlled trials (RCTs) which evaluated the efficacy of vitamin B in mild cognitive impairment (MCI) patients or elderly adults without cognitive impairment were selected. Standardized mean difference (SMD) or mean difference (MD) as well as their 95% confidence interval (CI) were calculated by performing random effects models or fixed effects models.Results: A total of 21 RCTs involving 7571 participants were included for meta-analysis. The forest plots showed that there is significant effect in global cognitive function (15 RCTs, SMD: 0.36; 95% CI: 0.18 to 0.54, P < 0.01) and Hcy (11 RCTs, MD: -4.59; 95%CI: -5.51 to -3.67, P < 0.01), but there is no effect in information processing speed (10 RCTs, SMD: 0.06; 95% CI: -0.12 to 0.25, P = 0.49), episodic memory (15 RCTs, SMD: 0.10; 95% CI: -0.04 to 0.25, P = 0.16), executive function (11 RCTs, SMD: -0.21; 95% CI: -0.49 to 0.06, P = 0.13). The value of effect size and heterogeneity did not vary apparently when excluding the low-quality studies, so we could believe that the results of meta-analysis were robust.Conclusions: Vitamin B supplement might delay or maintain the cognitive decline of elderly adults. We can recommend that the vitamin B supplement should be considered as a preventive medication to MCI patients or elderly adults without cognitive impairment. More well-designed RCTs with large sample sizes were required to clarify the preventive efficacy in the future.

scholarly journals The assessment of the efficiency of 5-methyltethydrofolate according to level by homocysteine, methionine and betaine in pregnant women with polymorphism rs 1801133 (677 C> T) of the MTHFR gene

2020 ◽  
Vol 24 (4) ◽  
pp. 618-623
Author(s):  
O. B. Lastovetska ◽  
O. V. Bulavenko
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Mthfr Gene ◽  
Folate Metabolism ◽  
Reproductive Age ◽  
Third Trimester ◽  
The Third ◽  
Serum Homocysteine ◽  
Significant Difference

Annotation. The prevention of early pregnancy loss, taking into account the polymorphism of the genes of enzymes that controlling folate metabolism, have become the goal of clinical studies in recent years, and the determination of risk factors for patients of late reproductive age and embryonic losses in history becomes critical for the development of effective measures to prevent miscarriage. The use of medical prevention of perinatal pathology using a biologically active form of folate in the form of 5-methyltetrahydrofolate in women with anamnestic loss of pregnancy looks promising. The aim of the study was to evaluate the effectiveness of drug prevention in patients with anamnestic embryonic losses, taking into account the role of the rs1801133 (677 C>T) polymorphism of the MTHFR gene based on the results of the dynamics of serum levels of homocysteine, betaine, and methionine. The patients were divided into the main group (polymorphism rs1801133 (677 C>T) of the MTHFR gene and anamnestic embryonic loss), which was divided into 2 subgroups: I subgroup included 20 women who received folic acid preparations (400 μg per day), II subgroup – 20 patients who received a complex preparation containing 5-methyltetrahydrofolate and control groups (practically healthy women) (n=20). Prescribing drugs began at the pre-gravid stage 8–10 weeks before pregnancy planning, and the administration ended up to 26 weeks of pregnancy. Determination of serum homocysteine levels and markers of folate metabolism - methionine and betaine – were performed at the end of the 1st – beginning of the 2nd trimester of pregnancy and in the third trimester. In the study of the effectiveness of preventive therapy on the dynamics of markers of folate metabolism functionality in pregnant women of late reproductive age with anamnestic embryonic losses and polymorphism rs1801133 (677 C>T) of the MTHFR gene when using a combined drug containing folic acid and 5-methyltetrahydrofolate, at the first end – at the beginning In the second trimester, there was a significant increase in betaine and methionine (p<0.05), while in the third trimester, a positive statistically significant difference (p<0.05) was diagnosed in an increase in methionine, betaine and a decrease in serum homocysteine levels.

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