口服维生素D对认知障碍老年人干预效果的系统评价

A systematic review of the intervention effect of oral vitamin D on the elderly with cognitive impairment

目的系统评价口服维生素D对认知障碍老年人的干预效果。方法检索PubMed、Embase、Cochrane Library、Web of Science、CBM、知网、万方和维普中建库至2021年2月1日有关口服维生素D对认知障碍老年人干预效果的随机对照试验文献。文献筛选、数据提取和偏倚风险评估由2名研究人员独立完成,最后利用Rev Man 5.4软件对数据进行Meta分析。结果最终纳入6篇文献,共829例患者,Meta分析结果显示:口服维生素D能有效提高认知障碍老年人的MMSE量表评分[MD=1.37,95%CI=(0.32,2.43),Z=2.55,P=0.01]和WAIS-RC量表评分[MD=8.80,95%CI=(7.14,10.46),Z=10.39,P<0.00001]。结论补充维生素D能有效改善认知障碍老年人的认知功能和执行能力,建议将维生素D运用到认知障碍老年人的临床治疗中。但改善认知障碍老年人认知功能和执行能力所需的最佳维生素D剂量和疗程尚无法确定,还有待更多样本量大、针对性强、质量高的RCT进一步验证。

Objective To systematically evaluate the intervention effect of oral vitamin D on the elderly with cognitive impairment.Methods Randomized controlled trials literature of PubMed,Embase,Cochrane Library,Web of Science,CBM,CNKI,Wanfang and VIP was searched for the efficacy of oral vitamin D intervention in the elderly with cognitive impairment from the data establishment to February 1,2021.Literature screening,data extraction and bias risk assessment were completed independently by two researchers.Finally,the Rev Man 5.4 software was used for Meta-analysis of the data.Results Finally,6 articles were included,829 patients in total.Meta analysis Results showed that oral vitamin D could effectively improve the MMSE scale scores of the elderly with cognitive impairment[MD=1.37,95%CI=(0.32,2.43),Z=2.55,P=0.01]and WAIS-RC scale scores[MD=8.80,95%CI=(7.14,10.46),Z=10.39,P<0.00001].Conclusion Vitamin D supplementation can effectively improve the cognitive function and executive ability of the elderly with cognitive impairment.It is suggested to apply vitamin D to the clinical treatment of the elderly with cognitive impairment.However,the optimal dose and course of treatment of vitamin D needed to improve cognitive function and executive ability of the elderly with cognitive impairment cannot be determined,and more RCTs with large sample size,strong pertinence and high quality need to be further verified.