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Epidemiological studies provide data that are potentially useful for addressing this research question, but the lack of analysis and reporting of data in a manner suitable for dose\u2013response purposes hinders the application of the traditional evidence synthesis process. This study aimed to estimate a quantitative dose\u2013response relationship between folate exposure and the risk of cognitive impairment among older adults with vitamin B12 deficiency using \u201cprobabilistic meta\u2010analysis,\u201d a novel approach for synthesizing data from observational studies. Second\u2010order multistage regression was identified as the best\u2010fit model for the association between the probability of cognitive impairment and serum folate levels based on data generated by randomly sampling probabilistic distributions with parameters estimated based on summarized information reported in relevant publications. The findings indicate a \u201cJ\u2010shape\u201d effect of serum folate levels on the occurrence of cognitive impairment. In particular, an excessive level of folate exposure is predicted to be associated with a higher risk of cognitive impairment, albeit with greater uncertainty than the association between low folate exposure and cognitive impairment. This study directly contributes to the development of a practical solution to synthesize observational evidence for dose\u2013response assessment purposes, which will help strengthen future nutritional risk assessments for the purpose of informing decisions on nutrient fortification in food.<\/jats:p>","DOI":"10.1111\/risa.13404","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T13:25:12Z","timestamp":1568899512000},"page":"276-293","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Assessment of the Dose\u2013Response Relationship Between Folate Exposure and Cognitive Impairment: Synthesizing Data from Documented Studies"],"prefix":"10.1111","volume":"40","author":[{"given":"Bing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Food Science and Technology University of Nebraska\u2010Lincoln  Lincoln NE USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine R.","family":"Sahyoun","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Science University of Maryland  College Park MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kan","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Indiana University  Bloomington IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enakshy","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Statistics University of Nebraska\u2010Lincoln  Lincoln NE USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Food Science and Technology University of Nebraska\u2010Lincoln  Lincoln NE USA"},{"name":"Department of Statistics University of Nebraska\u2010Lincoln  Lincoln NE USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2004.07.005"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.nutr.19.1.357"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.07.015"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.11-01-00147.1991"},{"key":"e_1_2_6_6_1","unstructured":"Benchmark Dose Software (BMDS) User Manual.(2016).BMDS version: 2.6.0.1. 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