Vitamin B12, B6, or Folate and Cognitive Function in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 77 (2) ◽  
pp. 781-794 ◽  
Author(s):  
Chenbo Zhang ◽  
Jianfeng Luo ◽  
Changzheng Yuan ◽  
Ding Ding

Background: Previous studies have indicated that B vitamin deficiencies are an essential cause of neurological pathology. There is a need to provide evidence of the benefit of B vitamins for the prevention of cognitive decline in community-dwelling older adults. Objective: To examine the association between intake and plasma levels of vitamins B12, B6, and folate and cognitive function in older populations through a systematic review and meta-analysis. Methods: Medline (PubMed), EMBASE, and Cochrane databases were used to search the literature though August 8, 2019. We included observational population-based studies evaluating the association between concentrations or intake levels of vitamins B6, B12, or folate and cognition in older adults aged ≥45 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale. Odds ratios (ORs) and hazard ratios (HRs) were analyzed by the random-effects model. Sensitivity analyses were conducted by excluding the studies with significant heterogeneity. Results: Twenty-one observational studies with sample sizes ranging from 155–7030 were included in the meta-analysis. Higher levels of vitamin B12 (OR = 0.77, 95% CI = 0.61–0.97) and folate concentration (OR = 0.68, 95% CI = 0.51–0.90) were associated with better cognition in cross-sectional studies, but not in sensitivity analyses or prospective studies. High vitamin B6 concentrations showed no significant benefit on cognition and dementia risk. Prospective studies did not provide substantial evidence for the relationship. Conclusion: The results from our meta-analysis suggest that vitamins B12, B6, and folate may not be modifiable risk factors for slowing cognitive decline among community-dwelling older individuals.

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033602
Author(s):  
Deborah A Jehu ◽  
Jennifer C Davis ◽  
Teresa Liu-Ambrose

IntroductionOlder adults who fall recurrently (i.e., >1 fall/year) are at risk for functional decline and mortality. Key risk factors for recurrent falls in community-dwelling older adults are not well established due to methodological limitations, such as recall bias. A better understanding of the risk factors for recurrent falls will aid in refining clinical practice guidelines for secondary fall prevention strategies. The primary objective of this systematic review with meta-analysis is to examine the risk factors for recurrent falls in prospective studies among community-dwelling older adults.Methods and analysisA comprehensive search for articles indexed in MEDLINE, EMBASE, PsycINFO and CINAHL databases as well as grey literature was conducted on April 25, 2019. We will use MeSH and keyword search terms around the following topics: falls, recurrence, fall-risk, ageing and prospective studies. Prospective studies with monthly falls monitoring for 12 months, investigating risk factors for recurrent falls in older adults will be included. One author will complete the search. Two authors will remove duplicates and screen the titles and abstracts for their potential inclusion against the eligibility criteria. Two authors will screen the full texts and extract the data using a piloted extraction sheet. Included studies will be evaluated for the risk of bias with the Joanna Briggs Institute Prevalence Critical Appraisal tools. The quality of reporting will be determined with the Strengthening the Reporting of OBservational studies in Epidemiology. The data extraction will include study characteristics as well as sociodemographic, balance and mobility, sensory and neuromuscular, psychological, medical, medication and environmental factors. The results will be presented via figures, summary tables, meta-analysis (when possible) and narrative summaries.Ethics and disseminationNo ethics approval will be required. Findings will be disseminated through publication and media.PROSPERO registration numberCRD42019118888; Pre-results.


Author(s):  
Mei-Lan Chen ◽  
Stephanie B. Wotiz ◽  
Starr M. Banks ◽  
Sabine A. Connors ◽  
Yuyin Shi

Previous studies indicated that Tai Chi might be an effective way to improve or prevent cognitive impairments in older populations. However, existing research does not provide clear recommendations about the optimal dose of Tai Chi practice, which is the most effective in improving cognitive function in older adults. The purpose of this systematic review and meta-analysis was to investigate the dose–response relationship between Tai Chi and cognition in community-dwelling older adults. A total of 16 studies with 1121 subjects were included in this study. Meta-regression analyses of Tai Chi duration (Tai Chi session duration, Tai Chi practice duration per week, study duration, and Tai Chi practice duration for the entire study) on the study effect size (ES) were performed to examine the dose–response association of Tai Chi and cognition. The results showed that there was a positive effect of Tai Chi on cognitive function, but there were no statistically significant dose duration effects on cognition. The findings suggest that Tai Chi has beneficial effects on cognitive function, but a longer duration was not associated with larger effects. In order to establish evidence-based clinical interventions using Tai Chi, future research should clearly demonstrate intervention protocol, particularly the style and intensity of Tai Chi.


Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 567
Author(s):  
Akio Goda ◽  
Shin Murata ◽  
Hideki Nakano ◽  
Koji Nonaka ◽  
Hiroaki Iwase ◽  
...  

Few studies have examined the effects of health literacy on people at risk of developing dementia; its effects on the pathogenesis of subjective cognitive decline (SCD) are particularly unclear. This study aimed to clarify the relationship between health literacy and SCD in a population of healthy community-dwelling older adults. SCD status was assessed using the Cognitive Function domain of the Kihon Checklist (KCL-CF). Health literacy, in turn, was evaluated using the Communicative and Critical Health Literacy (CCHL) scale. Global cognitive function and depressive symptoms were evaluated using the Mini-Mental State Examination (MMSE) and a five-item version of the Geriatric Depression Scale (GDS-5), respectively. Participants who were suspected of having SCD were significantly older than their non-SCD peers, and scored significantly worse on the CCHL, MMSE, and GDS-5. In addition, SCD status was found to be associated with CCHL and GDS-5 scores, as well as age, according to a logistic regression analysis. These findings suggest that low health literacy is linked to SCD morbidity in healthy community-dwelling older adults and should prove useful in the planning of dementia prevention and intervention programs for this population.


Pain Medicine ◽  
2014 ◽  
Vol 15 (7) ◽  
pp. 1115-1128 ◽  
Author(s):  
Brendon Stubbs ◽  
Pat Schofield ◽  
Tarik Binnekade ◽  
Sandhi Patchay ◽  
Amir Sepehry ◽  
...  

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