血清维生素B_(12)水平与老年认知障碍关系

Association between serum vitamin B_(12) level and cognitive impairment in Chinese elderly residents:a CLHLS dataset-based analysis

目的 探讨血清维生素B_(12)水平与老年认知障碍的关系,为老年认知障碍的防控提供参考依据。方法 以2012-2014年中国老年健康影响因素跟踪调查中924名年龄≥65岁老年人为研究对象,采用简易精神状态检查量表(MMSE)评估认知功能,认知障碍定义为MMSE得分<24分。按照血清维生素B_(12)水平的三分位数分组并比较各组间的基本特征,采用广义估计方程评估血清维生素B_(12)水平与老年认知功能水平和认知障碍患病风险的关联。结果 共纳入924名研究对象,平均年龄为(81.21±11.14)岁,49.89%(461人)为女性,血清维生素B12平均水平为(408.93±197.60) pmol/L。经多因素调整后,以血清维生素B12水平Q1组为参照,Q2(β=1.12,95%CI=0.40~1.85)和Q3(β=1.34,95%CI=0.52~2.16)组的MMSE得分均升高;并且Q2组和Q3组人群患认知障碍的风险分别是Q1组的0.52倍(OR=0.52,95%CI=0.32~0.86)和0.56倍(OR=0.56,95%CI=0.33~0.94)。按性别亚组分析,女性结果与总体相似,男性中关联未发现有统计学意义。结论 在我国老年女性人群中,血清维生素B_(12)缺乏与认知障碍存在正相关关系。

Objective To investigate the association between serum vitamin B_(12)(VB_(12))level and cognitive impairment in elderly Chinese individuals for the prevention and control of cognitive decline in the population.Methods The data of 924 residents aged 65 years and older were extracted from the dataset of Chinese Longitudinal Healthy Longevity Survey(CLHLS)conducted in 2012 and 2014.Cognitive function was assessed using the Mini-Mental State Examination(MMSE),with participants scoring below 24 considered to have cognitive impairment.Participants were categorized into tertiles based on their serum VB_(12) concentrations,and comparisons were made between major characteristics of participants in different groups.Generalized estimation equation(GEE)models were employed to explore the association of serum VB_(12) level with cognitive function and its risk.Results The mean level of serum VB_(12) was 408.93±197.60 pmol/L for all the participants aged 81.21±11.14 years and with nearly equal numbers of men and women.After adjusting for potential confounders,the GEE model analyses revealed that compared to individuals with serum VB12 levels in the first tertile,the participants with higher serum VB_(12) levels exhibited increased MMSE scores(β=1.12,95% confidence interval[95%CI]:0.40-1.85 for the second tertile;β=1.34,95%CI=0.52-2.16 for the third tertile),as well as a reduced risk of cognitive impairment(odds ratio[OR]=0.52,95%CI:0.32-0.86 for the second tertile;OR=0.56,95%CI:0.33-0.94) for the third tertile.However,further subgroup analysis indicated that the decreased risk of cognitive impairment was statistically significant only among female participants.Conclusion The presence of serum vitamin B_(12) deficiency is significantly associated with cognitive impairment in elderly female residents in China.