Eileen M Moore1, David Ames2, Alastair G Mander3, Ross P Carne4, Henry Brodaty5, Michael C Woodward6, Karyn Boundy7, Kathryn A Ellis8, Ashley I Bush9, Noel G Faux10, Ralph N Martins11, Colin L Masters12, Christopher C Rowe13, Cassandra Szoeke14, David A Watters4. 1. Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia Barwon Health, Geelong, VIC, Australia. 2. Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia National Ageing Research Institute, Parkville, VIC, Australia. 3. Barwon Health, Geelong, VIC, Australia. 4. Barwon Health, Geelong, VIC, Australia Deakin University, School of Medicine, Waurn Ponds, VIC, Australia. 5. The University of New South Wales, Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, Sydney, NSW, Australia Aged Care Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia. 6. Austin Health, Heidelberg Repatriation Hospital, Heidelberg, VIC, Australia. 7. The Queen Elizabeth Hospital, Woodville South, SA, Australia. 8. Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia National Ageing Research Institute, Parkville, VIC, Australia The University of Melbourne, Florey Institute of Neuroscience & Mental Health, Parkville, VIC, Australia. 9. The University of Melbourne, Florey Institute of Neuroscience & Mental Health, Parkville, VIC, Australia Department of Pathology, The University of Melbourne, Parkville, VIC, Australia. 10. The University of Melbourne, Florey Institute of Neuroscience & Mental Health, Parkville, VIC, Australia. 11. Edith Cowan University, Centre of Excellence for Alzheimer's Disease Research & Care, School of Exercise, Biomedical and Health Sciences, Joondalup, WA, Australia Sir James McCusker Alzheimer's Disease Research Unit (Hollywood Private Hospital), Neurosciences Unit, Health Department of Western Australia, Perth, WA, Australia. 12. The University of Melbourne, Florey Institute of Neuroscience & Mental Health, Parkville, VIC, Australia The University of Melbourne, Centre for Neuroscience, Parkville, VIC, Australia. 13. Austin PET centre, Austin Hospital, Heidelberg, VIC, Australia. 14. National Ageing Research Institute, Parkville, VIC, Australia Preventative Health Flagship, Commonwealth Science Industry Research Organization, Parkville, VIC, Australia.
Abstract
BACKGROUND: Folate fortification of food aims to reduce the number of babies born with neural tube defects, but has been associated with cognitive impairment when vitamin B12 levels are deficient. Given the prevalence of low vitamin B12 levels among the elderly, and the global deployment of food fortification programs, investigation of the associations between cognitive impairment, vitamin B12, and folate are needed. OBJECTIVE: To investigate the associations of serum vitamin B12, red cell folate, and cognitive impairment. METHODS: Data were collected on 1,354 subjects in two studies investigating cognitive impairment, and from patients attending for assessment or management of memory problems in the Barwon region of south eastern Australia between 2001 and 2011. Eligible subjects who had blood measurements of vitamin B12 and red cell folate taken within six months of cognitive testing were included. Subjects with stroke or neurodegenerative diseases other than Alzheimer's disease were excluded. A Mini-Mental State Examination score of <24 was used to define impaired cognitive function. RESULTS: Participants with low serum vitamin B12 (<250 pmol/L) and high red cell folate (>1,594 nmol/L) levels were more likely to have impaired cognitive performance (adjusted odds ratio (AOR) 3.45, 95% confidence interval (CI): 1.60-7.43, p = 0.002) when compared to participants with biochemical measurements that were within the normal ranges. Participants with high folate levels, but normal serum vitamin B12, were also more likely to have impaired cognitive performance (AOR 1.74, 95% CI: 1.03-2.95, p = 0.04). CONCLUSIONS: High folate or folic acid supplements may be detrimental to cognition in older people with low vitamin B12 levels. This topic is of global significance due to the wide distribution of food fortification programs, so prospective studies should be a high priority.
BACKGROUND:Folate fortification of food aims to reduce the number of babies born with neural tube defects, but has been associated with cognitive impairment when vitamin B12 levels are deficient. Given the prevalence of low vitamin B12 levels among the elderly, and the global deployment of food fortification programs, investigation of the associations between cognitive impairment, vitamin B12, and folate are needed. OBJECTIVE: To investigate the associations of serum vitamin B12, red cell folate, and cognitive impairment. METHODS: Data were collected on 1,354 subjects in two studies investigating cognitive impairment, and from patients attending for assessment or management of memory problems in the Barwon region of south eastern Australia between 2001 and 2011. Eligible subjects who had blood measurements of vitamin B12 and red cell folate taken within six months of cognitive testing were included. Subjects with stroke or neurodegenerative diseases other than Alzheimer's disease were excluded. A Mini-Mental State Examination score of <24 was used to define impaired cognitive function. RESULTS:Participants with low serum vitamin B12 (<250 pmol/L) and high red cell folate (>1,594 nmol/L) levels were more likely to have impaired cognitive performance (adjusted odds ratio (AOR) 3.45, 95% confidence interval (CI): 1.60-7.43, p = 0.002) when compared to participants with biochemical measurements that were within the normal ranges. Participants with high folate levels, but normal serum vitamin B12, were also more likely to have impaired cognitive performance (AOR 1.74, 95% CI: 1.03-2.95, p = 0.04). CONCLUSIONS: High folate or folic acid supplements may be detrimental to cognition in older people with low vitamin B12 levels. This topic is of global significance due to the wide distribution of food fortification programs, so prospective studies should be a high priority.
Authors: Lindsay H Allen; Joshua W Miller; Lisette de Groot; Irwin H Rosenberg; A David Smith; Helga Refsum; Daniel J Raiten Journal: J Nutr Date: 2018-12-01 Impact factor: 4.798
Authors: Hathairat Sawaengsri; Peter R Bergethon; Wei Qiao Qiu; Tammy M Scott; Paul F Jacques; Jacob Selhub; Ligi Paul Journal: Am J Clin Nutr Date: 2016-10-12 Impact factor: 7.045