Cognitive Impairment

Women in the highest quartile of plasma vitamin B12 levels during mid-life score significantly higher on cognitive function tests in later years and are cognitively equivalent to those 4 years younger (Kang & Grodstein 2005). Supplementation with vitamin B12 significantly reverses impaired mental function in individuals with preexisting low levels (Healton et al 1991, Miller 2003, Refsum & Smith 2003, Tripathi et al 2001, Weir & Scott 1999). A complete recovery was observed in 61% of people with mental impairment due to low levels of vitamin B12, according to one study (Healton et al 1991). It is unclear whether vitamin B12 (and folate) deficiency exacerbates a pre-existing but undiagnosed pathological condition or whether it may cause cognitive decline even in normal subjects (Moretti et al 2004). Prevention of cognitive impairment when associated with elevated homocysteine Hyperhomocysteinaemia has been shown to be an independent risk factor for cognitive dysfunction, as both indirect and direct vascular damage can be caused by homocysteine. It has also been implicated in vascular dementia, with an increased risk of multiple brain infarcts and dementia as homocysteine levels rise. As a © 2007 Elsevier Australia

result, the homocystelne-lowerlng action of vitamin B12 provides a theoretical basis for its use in these cases.

One study of 370 non-demented 75-year-olds found a twofold increased risk of developing Alzheimer's dementia in subjects with low serum levels of vitamin B12 and folate over a 3-year period (Wang et al 2001).

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