Meta AnalysisID 5038

痴呆患者的同型半胱氨酸、维生素B6、B12和叶酸及维生素B治疗对认知功能的影响

CRD42019146727

To investigate the relationship between B vitamins and dementia from three perspectives: 1. A comparison of the different types of dementia and healthy controls, in terms of the concentrations of vitamin B12, vitamin B6,

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Record Fields

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Meta Analysis Id
5038
Evidence Id
13596
Core Evidence Id
13596
Source Meta Analysis Id
5021
Herb2 Meta Analysis Id
HBMA005021
Crd Id
CRD42019146727
Title
Homocysteine, vitamin B6, B12 and folic acid in patients with dementia, and vitamin B treatment effects on cognitive performance
Review Question
To investigate the relationship between B vitamins and dementia from three perspectives: 1. A comparison of the different types of dementia and healthy controls, in terms of the concentrations of vitamin B12, vitamin B6, folic acid (FA) and homocysteine (Hcy) in blood or cerebrospinal fluid; 2. An analysis of the dietary intake of B vitamins, and comparison of the risk of dementia in people with different intakes; 3. An assessment of the effects of supplementation with B12/B6/FA, and to analyze changes in MMSE (Mini-Mental State Examination) scores in intervention and placebo populations, differences in changes in blood concentrations of Hcy, and to evaluate B vitamin supplement effects on dementia.
Study Type Included
The following types of study will be included for the three parts of the review (see Field #15, Review question): 1. Cross-sectional, and a small number of cohort studies only extracted cross-sectional data on the concentrations of B12, B6, FA, and Hcy in various dementia patients; 2. Longitudinal cohort studies; 3. RCTs.
Condition Being Studied
Dementia is one of the most devastating chronic diseases in the elderly. It belongs to a group of conditions known as multiple degenerative encephalopathy, and is characterized by memory loss, cognitive dysfunction, and loss of self-care ability. Dementia has become a global problem, with about one in five people over the age of 75 suffering with the condition, and about 50 million people diagnosed worldwide, a figure which is expected to reach 75 million by 2030 (and which may even reach 132 million by 2050). Dementia is the main cause of physical disability, dependence on others and declining quality of life, and the cost of care for dementia in the world in 2018 is as high as $1 trillion, placing a heavy burden on society and families. At present, however, treatment can only delay the development of dementia, and we so far lack effective curative means, and a clear understanding of the pathogenesis of dementia. In recent years, research on the prevention and treatment of dementia has attracted much attention, and has become the focus of global health work through effective preventive measures to reduce the risk of dementia or delay the onset of dementia.
Participant
Patients with dementia (dementia of different types will be included).
Animal
Human Disease Modelled
Intervention
Homocysteine, vitamin B6, B12 and folic acid levels in patients with dementia, and vitamin B treatment effects on cognitive performance. The following will be addressed: 1. Patients with different types of dementia will be compared with healthy controls in terms of their B12, B6, FA, Hcy concentrations in blood or cerebrospinal fluid; 2. Dietary intakes of B vitamins will be assessed, the risk of dementia among people with different intakes compared; 3. The effects of supplementation with B12/B6/FA will be determined, and changes in MMSE scores in intervention and placebo populations and differences in changes in Hcy blood concentrations assessed.
Comparator Control
The following comparisons will made: 1. Vitamin B12, B6, FA or Hcy levels in blood or cerebrospinal fluid will be compared for different types of dementia and healthy controls (comparators/controls: different types of dementia and healthy controls); 2. The risk of dementia among people with different dietary B vitamin intakes will be assessed (control: people with a higher intake than the RDC (Recommended Dietary Allowance) or higher intake group); 3. Supplementation with B12/B6/FA will be compared, and changes in MMSE scores in intervention and placebo populations compared, and differences in changes in Hcy blood concentrations assessed (control: placebo).
Main Outcome
1. To divide dementia into four types AD/VAD/DOC (dementia due to other causes)/MCI, and evaluate the mean difference in homocysteine, vitamin B6, B12 and folic acid concentrations compared with healthy controls. 2. To calculate the odds ratio (OR) of dementia or cognitive decline between patients with higher and lower FA/B12/Hcy concentrations. 3. To calculate hazard ratios of dementia of dietary intakes of less than RDC vs more than RDC (i.e., less intake vs more intake). 4. To calculate the mean difference in the change in Hcy concentration and cognitive decline between patients receiving B vitamin supplement and placebo. Measures of effect 1. Evaluated as the baseline mean difference in concentration compared with that of healthy controls. 2. The odds ratio (OR) of dementia or cognitive decline, measured using MMSE at baseline. 3. Hazard ratio of dementia from baseline to the last available follow-up. 4. Mean difference of change in Hcy concentration and MMSE score, measured at three time periods, from randomisation to 6 months, 12 months, and 12 months later.
Outcome Measure
Additional Outcome
The correlation R between Hcy and FA, B12, and the correlation between MMSE score and FA, B12, and Hcy. Measures of effect Correlation R will be obtained at the baseline.
Study Method
Epidemiologic, Intervention, Meta-analysis, Systematic review
Keyword
Alzheimer Disease; Blood; Cerebrospinal Fluid; Cognition; Cognitive Dysfunction; Dementia; Dietary Supplements; Folic Acid; Homocysteine; Humans; Nutritional Requirements; Risk; Risk Factors; Treatment Outcome; Vitamin B 12; Vitamin B 6; Vitamin B Complex
Contact
Yi Tang [email protected]
Organisational Affiliation
Xuanwu Hospital, Capital Medical University www.xwhosp.com.cn
Funding Source
This work is being supported by the National Key R&D Program of China [grant number 2017YFC1310102]; and the National Natural Science Foundation of China [grant number 81671040]
Other Selection Criteria
Final Publication
Same Topic Review
Published Protocol
Review Type
Language
English
Country
China
Review Stage
Review Ongoing
First Submission Date
2019-08-09
Registration Date
2019-11-20
Anticipated Start Date
2019-07-02
Anticipated Completion Date
2019-09-30
Title Cn
痴呆患者的同型半胱氨酸、维生素B6、B12和叶酸及维生素B治疗对认知功能的影响
Title En
Homocysteine, vitamin B6, B12 and folic acid in patients with dementia, and vitamin B treatment effects on cognitive performance
Bilingual Status
complete