关于用叶酸(FA)强制强化食物的政策可能会影响基于叶酸的B族维生素治疗对老年人认知功能的有效性。我们批判性和系统地回顾了文献,以评估食物强化政策是否会影响基于叶酸的B族维生素治疗对老年人认知功能的功效。电子数据库,包括PubMed,WebofScience,和CNKI,搜索“认知功能”,\"叶酸\",和“老年人”。这项研究有具体的纳入标准,具体如下:(1)这些研究最初应该有针对60岁或以上老年人的随机对照试验;(2)这些研究必须评估叶酸状态和认知能力之间的关系;(3)这些研究应该阐明关于FA强化食物的政策.本审查遵循了系统审查和荟萃分析(PRISMA)报告指南的首选报告项目。两名审阅者独立提取了所有数据,任何差异都以协商一致方式解决。收集的所有数据都经过汇编,比较,并进行了批判性分析。随机效应模型用于评估干预措施的效果。系统审查包括51篇文章,涉及42,768名参与者。其中,这23篇文章被纳入荟萃分析.基于叶酸的B族维生素补充剂对认知功能的影响的荟萃分析显示出显着的总体影响(Z=3.84;p=0.0001;SMD,0.18;95%CI,0.09,0.28)。进一步的分析显示,以叶酸为基础的B族维生素补充剂可改善老年人认知障碍的国家未实施FA食品强化政策(Z=3.75;p=0.0002;SMD,0.27;95%CI,0.13,0.40)。然而,FA干预在FA食品强化政策强制性的地区没有显著结果(Z=0.75;p=0.45;SMD,0.03;95%CI,-0.06,0.13)。补充口服叶酸,单独或组合,与老年人认知能力的改善有关。虽然强制性FA强化改善了叶酸状态,额外的基于叶酸的B族维生素补充剂似乎不会影响认知功能。
The policies regarding the mandatory fortification of food with folic acid (FA) may impact the effectiveness of folate-based B vitamin treatment on cognitive function in older adults. We critically and systematically review the literature to assess whether food fortification policies affect folate-based B vitamin treatment efficacy on cognition function in older adults. Electronic databases, including PubMed, Web of Science, and CNKI, were searched for \"Cognitive Function\", \"Folate\", and \"Older Adults\". The study had specific criteria for inclusion, which were as follows: (1) the studies should initially have randomized controlled trials that were conducted on older adults aged 60 or above; (2) the studies must assess the relationship between folate status and cognitive performance; and (3) the studies should clarify the policies regarding food fortification with FA. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Two reviewers independently extracted all the data, and any discrepancies were resolved by consensus. All the data collected were compiled, compared, and analyzed critically. Random effects models were used to assess the effects of interventions. The systematic review included fifty-one articles involving 42,768 participants. Of these, the 23 articles were included in the meta-analysis. The meta-analysis on the effects of folate-based B vitamin supplementation on cognitive function showed a significant overall impact (Z = 3.84; p = 0.0001; SMD, 0.18; 95% CI, 0.09, 0.28). Further analysis revealed that FA food fortification policies were not implemented in countries where folate-based B vitamin supplementation improved cognitive impairment in older adults (Z = 3.75; p = 0.0002; SMD, 0.27; 95% CI, 0.13, 0.40). However, the FA intervention did not have significant outcomes in areas where FA food fortification policies were mandatory (Z = 0.75; p = 0.45; SMD, 0.03; 95% CI, -0.06, 0.13). Supplementing with oral folic acid, alone or in combination, has been linked to improved cognitive performance in older adults. While mandatory FA fortification has the improved folic acid status, additional folate-based B vitamin supplements do not appear to influence cognitive function.