Association between mild cognitive impairment and the nutritional status of folate and vitamin B12 in the community-dwelling elderly people
Objective To explore the correlation between multidimensional nutritional evaluation indexes of folate and vitamin B12 and mild cognitive impairment in community-dwelling older adults.Methods In this study,cross-sectional study design was used,and the elderly people aged 60 years and above were recruited from three parallel communities in Shijiazhuang City.The survey was conducted including basic information questionnaire and semi-quantified food frequency questionnaires(FFQ)in the past year.The Montreal Cognitive Assessment Scale(MoCA)assessed the cognitive function.The subjects were divided into two groups of normal cognition and mild cognitive impairment according to the criteria categorized by education levels recommended by the 2018 China Dementia and Cognitive Impairment Diagnosis and Treatment Guidelines.Serum folate,vitamin B12 and erythrocyte folate levels were measured by electrochemiluminescence immunoassay,serum homocysteine concentrations were measured by circulating enzyme assay,dietary folate and vitamin B12 intake was calculated by FFQ survey and food composition tables.Logistic regression models were used to analyze the association between multidimensional nutritional indicators of folate and vitamin B12 and mild cognitive impairment.Results A total of 537 subjects were included in the study,involving 379(70.6％)with normal cognition and 158(29.4％)with mild cognitive impairment.Dietary vitamin B12 intake and erythrocyte folate concentration was significantly lower in the elderly with mild cognitive impairment than in those with normal cognition[median(interguartile):18.9(11.0,32.9)μg/d vs.20.1(14.2,34.8)μg/d,Z=2.010,P=0.044;median:359.4(304.2,413.4)μg/L vs.378.4(322.5,433.1)μg/L,Z=2.168,P=0.031].The elderly with mild cognitive impairment had a higher prevalence of folate deficiency than those with normal cognition[17(10.8％)vs.22(5.8％),x2=4.065,P=0.044].After adjusting for age,sex,and energy intake,the OR(95％CI)values for dietary vitamin B12 intake and erythrocyte folate concentration in relation to mild cognitive impairment in the elderly were 0.99(0.987,0.996)(P=0.039)and 0.98(0.974,0.993)(P=0.021),respectively.The OR(95％CI)values for folate deficiency for mild cognitive impairment was 1.96(1.009,3.795)(P=0.046).Conclusions Long-term high dietary vitamin B12 intake and better in vivo nutritional deposition of folate were negatively associated with mild cognitive impairment in community-dwelling elderly adults,whereas indicators reflecting the short-term nutritional status of folate and vitamin B12 may be less associated with mild cognitive impairment.
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