Association Between Cognitive Impairment and Vitamin B12, Folate, and Homocysteine Status in Elderly Adults: A Retrospective Study

Article type: Research Article

Authors: Baroni, Luciana^a | Bonetto, Chiara^b | Rizzo, Gianluca^{c; *} | Bertola, Caterina^a | Caberlotto, Livio^d | Bazzerla, Giorgio^a

Affiliations: [a] Primary Care Unit, Local Health Unit 2 – Marca Trevigiana, Treviso, Italy | [b] Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy | [c] Scientific Society for Vegetarian Nutrition (SSVN), Mestre (VE), Italy | [d] Central Laboratory Ca’ Foncello Hospital, Local Health Unity 2 – Marca Trevigiana, Treviso, Italy

Correspondence: [*] Correspondence to: Gianluca Rizzo, Scientific Society for Vegetarian Nutrition (SSVN), Via Verdi 10/9, Mestre (VE) 30171, Italy. Tel.: +39 320 8976 687; E-mail: gianlucarizzo@email.it.

Abstract: Background:Cognitive disorders in old age have a serious impact on the health and social aspects of patients and their families. Objective:The scope of this paper is to explore the role of cobalamin and folate that has been linked to cognitive decline, not only as a deficiency state depending on malnutrition, but also a determinant in cognitive impairment. Methods:A 6-year observational, retrospective study was conducted by collecting the routine blood analyses and cognitive screening scores of patients aged 60 years or older, followed at our Centre for the Diagnosis and Treatment of Cognitive Disorders. Results:In a linear regression with a multi-vitamin model, higher folate concentrations were correlated with better cognitive performances through MMSE score, even after correction for sex, age, and years of education (beta = 0.144, p = 0.001). Estimated MMSE marginal means for folate versus homocysteine showed that folate deficiency was associated with worse cognitive performances, with a more severe cognitive impairment when hyperhomocysteinemia was present. Conclusion:The assessment of B-vitamin status among elderly adults can contribute to an economic and practical approach to the prevention and management of cognitive decline. Future studies focused to define optimal vitamin status are warranted.

Keywords: Aged, Alzheimer’s disease, cognitive dysfunction, dementia, folic acid, homocysteine, mini-mental state examination, vitamin B 12

DOI: 10.3233/JAD-190249

Journal: Journal of Alzheimer's Disease, vol. 70, no. 2, pp. 443-453, 2019