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Effect of vitamin intake on cognitive decline in older adults: Evaluation of the evidence

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The journal of nutrition, health & aging

Abstract

Objectives

The objective of this review was to evaluate the evidence from human studies on the intake of vitamins, either as monotherapies or in combination with other vitamins, as neuroprotective agents that may delay the onset of cognitive decline in older adults.

Methods

Evidence-based methodologies were used to capture and evaluate the highest levels of evidence.

Findings

The current evidence available showed no association for cognitive benefits of vitamins B6 or B12 as a monotherapy, and recent systematic reviews provide no clear evidence that supplementation with vitamin B6, B12 and/or folic acid improves dementia outcomes or slows cognitive decline, even though it may normalise homocysteine levels. Meta-analyses from systematic reviews have shown an association between low vitamin D levels and diminished cognitive function, although causality cannot be confirmed from the available evidence. There is no convincing evidence for an association of vitamin A, vitamin C or vitamin E either as a monotherapy or in combination with other antioxidant vitamins such as β-carotene and the prevention of cognitive decline. The appraisal of nineteen systematic reviews and meta-analyses has highlighted the heterogeneity between studies, and the need for better consensus on definitions of cognitive decline, duration of testing and agreement on which specific endpoints are clinically relevant.

Conclusions

Evaluation of the totality of the currently available evidence indicates that intake of the above vitamins, either as a monotherapy, or in combination with other vitamins, has no clinically-relevant effect on delaying cognitive decline or delaying the onset of dementia in older adults.

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Abbreviations

25OHD:

25-hydroxyvitamin D

AD:

Alzheimer’s Disease

ADAS-cog:

Alzheimer’s Disease Assessment Scale-Cognitive Subscale

AIBL:

Australian Imaging, Biomarkers and Lifestyle study

CAMCOG:

Cambridge Cognitive Examination

CHAP:

Chicago Healthy Aging Project

CDR:

Clinical Dementia Rating Scale

CSF:

Cerebrospinal fluid

DARE:

Database of review of effects

HC:

Healthy control

holoTC:

Holotranscobalamin

IOM:

Institute of Medicine

JBI:

Joanna Briggs Institute (JBI)

MCI:

Mild cognitive impairment

MMA:

Methyl malonic acid (MMA)

MMSE:

Mini-Mental State Examination

NHMRC:

National Health and Medical Research Council

NHS EED:

National Health Service Economic Evaluation Database

PIB-PET:

Pittsburgh compound B Positron Emission Tomography

PLP:

pyridoxal phosphate

RCT:

Randomised controlled trial

TICS:

Telephone Interview of Cognitive Status

RR:

Relative risk

SMD:

Standardised mean difference

UVB:

Ultraviolet B

VITACOG:

Homocysteine and B vitamins in cognitive impairment RCT study

WMD:

Weighted mean difference

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Authors and Affiliations

  1. CSIRO Food and Nutrition Flagship, Werribee, 3030, Victoria, Australia

    Debra Krause & P. Roupas

  2. CSIRO Food and Nutrition Flagship, Private Bag 16, 671 Sneydes Road, Werribee, 3030, Victoria, Australia

    Debra Krause

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  1. Debra Krause
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Correspondence to Debra Krause.

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Krause, D., Roupas, P. Effect of vitamin intake on cognitive decline in older adults: Evaluation of the evidence. J Nutr Health Aging 19, 745–753 (2015). https://doi.org/10.1007/s12603-015-0539-3

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  • DOI: https://doi.org/10.1007/s12603-015-0539-3

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