Nutrición Hospitalaria 04394 / http://dx.doi.org/10.20960/nh.04394
Resumen| PDF (ENGLISH)

Trabajo Original

Vitamin B12 supplementation improves cognitive function in middle aged and elderly patients with cognitive impairment


Li Zhou, Xue Bai, Jiagui Huang, Yongjun Tan, Qin Yang

Prepublicado: 2023-06-13
Publicado: 2023-07-28

Logo Descargas   Número de descargas: 583      Logo Visitas   Número de visitas: 3032      Citas   Citas: 0

Compártelo:


Objectives: to determine the effects of vitamin B12 supplementation on neuropsychological function and disease progression in middle aged and elderly patients with cognitive impairment. Methods: this was a prospective case-control study. From May 2020 to May 2021, 307 participants clinically diagnosed with cognitive impairment in the Department of Neurology of the First Affiliated Hospital of Chongqing Medical University were enrolled. A total of 115 patients were included in this study. Meanwhile, 115 participants with cognitive impairment were randomly assigned in equal proportions to two groups: vitamin B12 treatment group (n = 58, vitamin B12 500 mg/d intramuscularly for seven days, followed by cobamamide 0.25 mg/d and methylcobalamin 0.50 mg/d) and the control group (n = 57). Demographic characteristics and blood biochemical variables were obtained from all participants. Cognitive performance was measured using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Cognitive performance was measured at baseline and after six months. Results: the vitamin B12 supplementation treatment patients who presented with cognitive impairment showed significant improvement, especially in attention, calculation (p < 0.01) and visual-constructional ability (p < 0.05), in their neuropsychological function compared to their matched group. Conclusion: vitamin B12 supplementation may improve frontal function in patients with cognitive decline. Vitamin B12 levels should be investigated in all patients with cognitive impairment.

Palabras Clave: Vitamin B12. Cobalamin. Cognitive impairment. Middle aged and elderly. Frontal function.



Scarmeas N, Anastasiou CA, Yannakoulia M. Nutrition and prevention of cognitive impairment. Lancet Neurol. 2018;17:1006-1015.
DOI: 10.1016/S1474-4422(18)30338-7
GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18:459-480.
DOI: 10.1016/S1474-4422(18)30499-X
Plassman BL, Langa KM, Fisher GG, Heeringa SG, Weir DR, Ofstedal MB, et al. Prevalence of cognitive impairment without dementia in the United States. Ann Intern Med. 2008;148:427-34.
DOI: 10.7326/0003-4819-148-6-200803180-00005
4 Jack CR Jr, Albert MS, Knopman DS, McKhann GM, Sperling RA, Carrillo MC, et al. Introduction to the recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:257-62.
DOI: 10.1016/j.jalz.2011.03.004
Jia L, Quan M, Fu Y, Zhao T, Li Y, Wei C, et al. Dementia in China: epidemiology, clinical management, and research advances. Lancet Neurol. 2020;19:81-92.
DOI: 10.1016/S1474-4422(19)30290-X
6 Heyssel RM, Bozian RC, Darby WJ, Bell MC. Vitamin B12 turnover in man. The assimilation of vitamin B12 from natural foodstuff by man and estimates of minimal daily dietary requirements. Am J Clin Nutr. 1966;18:176-84.
Green R, Allen LH, Bjørke-Monsen AL, Brito A, Guéant JL, Miller JW, et al. Vitamin B12 deficiency. Nat Rev Dis Primers. 2017 Jun 29;3:17040.
DOI: 10.1038/nrdp.2017.54
Wong CW, Ip CY, Leung CP, Leung CS, Cheng JN, Siu CY. Vitamin B12 deficiency in the institutionalized elderly: A regional study. Exp Gerontol. 2015;69:221-5.
DOI: 10.1016/j.exger.2015.06.016
Wong CW, Leung CS, Leung CP, Cheng JN. Association of metformin use with vitamin B12 deficiency in the institutionalized elderly. Arch Gerontol Geriatr. 2018;79:57-62.
DOI: 10.1016/j.archger.2018.07.019
Lindenbaum J, Rosenberg IH, Wilson PW, Stabler SP, Allen RH. Prevalence of cobalamin deficiency in the Framingham elderly population. Am J Clin Nutr. 1994;60:2-11.
DOI: 10.1093/ajcn/60.1.2
Loikas S, Koskinen P, Irjala K, Löppönen M, Isoaho R, Kivelä SL, et al. Vitamin B12 deficiency in the aged: a population-based study. Age Ageing. 2007;36:177-83.
DOI: 10.1093/ageing/afl150
Giedyk M, Goliszewska K, Gryko D. Vitamin B12 catalysed reactions. Chem Soc Rev. 2015;44:3391-404.
DOI: 10.1039/C5CS00165J
Lyon P, Strippoli V, Fang B, Cimmino L. B Vitamins and One-Carbon Metabolism: Implications in Human Health and Disease. Nutrients. 2020;12:2867.
DOI: 10.3390/nu12092867
Sahu P, Thippeswamy H, Chaturvedi SK. Neuropsychiatric manifestations in vitamin B12 deficiency. Vitam Horm. 2022;119:457-470.
DOI: 10.1016/bs.vh.2022.01.001
Spence JD. Metabolic vitamin B12 deficiency: a missed opportunity to prevent dementia and stroke. Nutr Res. 2016;36:109-16.
DOI: 10.1016/j.nutres.2015.10.003
Soh Y, Lee DH, Won CW. Association between Vitamin B12 levels and cognitive function in the elderly Korean population. Medicine (Baltimore). 2020;99:e21371.
DOI: 10.1097/MD.0000000000021371
Ma F, Zhou X, Li Q, Zhao J, Song A, An P, et al. Effects of Folic Acid and Vitamin B12, Alone and in Combination on Cognitive Function and Inflammatory Factors in the Elderly with Mild Cognitive Impairment: A Single-blind Experimental Design. Curr Alzheimer Res. 2019;16:622-632.
DOI: 10.2174/1567205016666190725144629
de Jager CA, Oulhaj A, Jacoby R, Refsum H, Smith AD. Cognitive and clinical outcomes of homocysteine-lowering B-vitamin treatment in mild cognitive impairment: a randomized controlled trial. Int J Geriatr Psychiatry. 2012;27:592-600.
DOI: 10.1002/gps.2758
Cheng D, Kong H, Pang W, Yang H, Lu H, Huang C, et al. B vitamin supplementation improves cognitive function in the middle aged and elderly with hyperhomocysteinemia. Nutr Neurosci. 2016;19:461-466.
DOI: 10.1179/1476830514Y.0000000136
Malouf M, Grimley EJ, Areosa SA. Folic acid with or without vitamin B12 for cognition and dementia. Cochrane Database Syst Rev. 2003;(4):CD004514.
DOI: 10.1002/14651858.CD004514
Kwok T, Wu Y, Lee J, Lee R, Yung CY, Choi G, et al. A randomized placebo-controlled trial of using B vitamins to prevent cognitive decline in older mild cognitive impairment patients. Clin Nutr. 2020;39:2399-2405.
DOI: 10.1016/j.clnu.2019.11.005
Kwok T, Lee J, Ma RC, Wong SY, Kung K, Lam A, et al. A randomized placebo controlled trial of vitamin B12 supplementation to prevent cognitive decline in older diabetic people with borderline low serum vitamin B12. Clin Nutr. 2017;36:1509-1515.
DOI: 10.1016/j.clnu.2016.10.018
Chen S, Honda T, Narazaki K, Chen T, Nofuji Y, Kumagai S. Global cognitive performance and frailty in non-demented community-dwelling older adults: Findings from the Sasaguri Genkimon Study. Geriatr Gerontol Int. 2016;16:729-36.
DOI: 10.1111/ggi.12546
Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 197;12:189-98.
DOI: 10.1016/0022-3956(75)90026-6
Ideno Y, Takayama M, Hayashi K, Takagi H, Sugai Y. Evaluation of a Japanese version of the Mini-Mental State Examination in elderly persons. Geriatr Gerontol Int. 2012;12:310-6.
DOI: 10.1111/j.1447-0594.2011.00772.x
Ismail Z, Rajji TK, Shulman KI. Brief cognitive screening instruments: an update. Int J Geriatr Psychiatry. 2010;25:111-20.
DOI: 10.1002/gps.2306
M Melikyan ZA, Malek-Ahmadi M, O'Connor K, Atri A, Kawas CH, Corrada MM. Norms and equivalences for MoCA-30, MoCA-22, and MMSE in the oldest-old. Aging Clin Exp Res. 2021;33:3303-3311.
DOI: 10.1007/s40520-021-01886-z
Serrano CM, Sorbara M, Minond A, Finlay JB, Arizaga RL, Iturry M, et al. Validation of the Argentine version of the Montreal Cognitive Assessment Test (MOCA): A screening tool for Mild Cognitive Impairment and Mild Dementia in Elderly. Dement Neuropsychol. 2020;14:145-152.
DOI: 10.1590/1980-57642020dn14-020007
Mahajan A, Sapehia D, Thakur S, Mohanraj PS, Bagga R, Kaur J. Effect of imbalance in folate and vitamin B12 in maternal/parental diet on global methylation and regulatory miRNAs. Sci Rep. 2019;9:17602.
DOI: 10.1038/s41598-019-54070-9
Costanzo M, Caterino M, Cevenini A, Jung V, Chhuon C, Lipecka J, et al. Proteomics Reveals that Methylmalonyl-CoA Mutase Modulates Cell Architecture and Increases Susceptibility to Stress. Int J Mol Sci. 2020;21:4998.
DOI: 10.3390/ijms21144998
Jatoi S, Hafeez A, Riaz SU, Ali A, Ghauri MI, Zehra M. Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia. Cureus. 2020;12:e6976.
DOI: 10.7759/cureus.6976
Durga J, van Boxtel MP, Schouten EG, Kok FJ, Jolles J, Katan MB, et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet. 2007;369:208-16.
DOI: 10.1016/S0140-6736(07)60109-3
Smith AD, Smith SM, de Jager CA, Whitbread P, Johnston C, Agacinski G, et al. Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One. 2010;5:e12244.
DOI: 10.1371/journal.pone.0012244
Sashindran VK, Aggarwal V, Khera A. Prevalence of Vitamin B12 deficiency in elderly population (>60 years) presenting with dementia to outpatient department. Med J Armed Forces India. 2022;78:94-98.
DOI: 10.1016/j.mjafi.2020.11.003
Eastley R, Wilcock GK, Bucks RS. Vitamin B12 deficiency in dementia and cognitive impairment: the effects of treatment on neuropsychological function. Int J Geriatr Psychiatry. 2000;15:226-33.
DOI: 10.1002/(SICI)1099-1166(200003)15:3<226::AID-GPS98>3.0.CO;2-K
Blundo C, Marin D, Ricci M. Vitamin B12 deficiency associated with symptoms of frontotemporal dementia. Neurol Sci. 2011;32:101-5.
DOI: 10.1007/s10072-010-0419-x
Lau H, Shahar S, Mohamad M, Rajab NF, Yahya HM, Din NC, et al. Relationships between dietary nutrients intake and lipid levels with functional MRI dorsolateral prefrontal cortex activation. Clin Interv Aging. 2018;14:43-51.
DOI: 10.2147/CIA.S183425

Artículos Relacionados:

Carta Editor: Importancia de descartar factor de riesgo por edad en la deficiencia de vitamina b12 inducida por uso de metformina

Gisela Cruz , Karina Maeshiro

Publicado: 2016-02-17 / http://dx.doi.org/10.20960/nh.33

Artículo Especial: Nutrición y deterioro cognitivo

Virgilio Hernando-Requejo

Publicado: 2016-07-12 / http://dx.doi.org/10.20960/nh.346

Trabajo Original: Patología neurológica por déficit de vitaminas del grupo b: tiamina, folato y cobalamina

Virgilio Hernando-Requejo

Publicado: 2018-09-07 / http://dx.doi.org/10.20960/nh.2289

Trabajo Original: Estudio exploratorio del vegetarianismo en restauración colectiva

Alejandro Martínez , Gaspar Ros , Gema Nieto

Publicado: 2018-09-20 / http://dx.doi.org/10.20960/nh.2314

Trabajo Original: Predicción del estado nutricional a través de la calidad de vida y el patrón del sueño en ancianos con deterioro cognitivo

Marta Lluesma Vidal , Sergio Murgui Pérez , José Vicente Carmona Simarro

Publicado: 2018-10-23 / http://dx.doi.org/10.20960/nh.2361

Revisión: Omega-3 fatty acids and cognitive decline: a systematic review

Amelia Martí del Moral , Francesca Fortique

Publicado: 2019-01-08 / http://dx.doi.org/10.20960/nh.02496

Nota Clínica: Encefalopatía grave y deficiencia de vitamina B12: reversibilidad tras la terapia nutricional

Javier Blasco-Alonso , Raquel Gil-Gómez , Ana García Ruiz , Marta Cortés Hernández , Guiomar Gutiérrez Schiaffino

Publicado: 2020-08-08 / http://dx.doi.org/10.20960/nh.03293

Trabajo Original: Adiposity-related risks among the middle-aged and elderly Chinese: the role of siesta and nocturnal sleep duration

Xiangyu Tang , Feifei Yao , Kangkang Liu

Publicado: 2020-11-23 / http://dx.doi.org/10.20960/nh.03448

Nota Clínica: Late-onset methylmalonic acidemia and homocysteinemia

Noemí Brox-Torrecilla , Loredana Arhip , María Miguélez-González , Sandra Castellano-Gasch , Ana Contreras-Chicote , María Luisa Rodríguez-Ferrero , Marta Motilla de la Cámara , Clara Serrano-Moreno , Cristina Cuerda

Publicado: 2021-03-24 / http://dx.doi.org/10.20960/nh.03623

Trabajo Original: Cuantificación, adecuación de la ingesta y fuentes alimentarias de nutrientes relacionados con el ciclo metionina-metilación (colina, betaína, folatos, vitamina B6 y vitamina B12) en mujeres embarazadas en España

Marina Redruello Requejo , Alejandra Carretero Krug , María de Lourdes Samaniego Vaesken , Teresa Partearroyo Cediel , Gregorio Varela Moreiras

Publicado: 2021-05-06 / http://dx.doi.org/10.20960/nh.03684

Nota Clínica: Nutritional imbalances in a Mexican vegan group: urgent need for country-specific dietary guidelines

Alan Espinosa-Marrón , Orlando Andrés Núñez-Issac , Angélica Moreno-Enríquez , Irving Sosa-Crespo , Jesús Alfredo Araujo-León , Fernanda Molina-Segui , Hugo Laviada-Molina

Publicado: 2021-08-04 / http://dx.doi.org/10.20960/nh.03819

Trabajo Original: La polimedicación en mayores institucionalizados; su efecto sobre los niveles de vitamina B12, folato y homocisteína

Publicado: 2021-09-28 / http://dx.doi.org/

Trabajo Original: El ejercicio agudo aumenta las concentraciones de homocisteína en varones físicamente activos

Publicado: 2021-10-19 / http://dx.doi.org/

Trabajo Original: Algorithm for the early diagnosis of vitamin B12 deficiency in elderly people

Publicado: 2021-10-27 / http://dx.doi.org/

Trabajo Original: Déficit de vitamina B12 asociado con altas dosis de metformina en adultos mayores diabéticos

Publicado: 2021-11-04 / http://dx.doi.org/

Nota Clínica: Cianocobalamina inhalada; una alternativa terapéutica eficaz y segura

Publicado: 2021-11-04 / http://dx.doi.org/

Nota Clínica: Combinación de acidemia metilmalónica y homocisteinuria; a propósito de un caso

Publicado: 2021-11-29 / http://dx.doi.org/

Trabajo Original: Asociación de la ingesta de macro y micronutrentes con calidad de vida en adultos mayores

Publicado: 2021-11-30 / http://dx.doi.org/

Trabajo Original: Undernutrition, serum vitamin B12, folic acid and depressive symptoms in older adults

Publicado: 2021-12-01 / http://dx.doi.org/

Revisión: Effect of eicosapentaenoic acid and docosahexaenoic acid supplementations to control cognitive decline in dementia and Alzheimer’s disease: a systematic review

Publicado: 2021-12-09 / http://dx.doi.org/

Trabajo Original: Folic acid and vitamin B12 as biomarkers of morbidity and mortality in patients with septic shock

Yénifer Gamarra-Morales , Jorge Molina-López , Lourdes Herrera-Quintana , Héctor Vázquez-Lorente , Elena Planells

Publicado: 2021-01-10 / http://dx.doi.org/10.20960/nh.03505

Trabajo Original: Prevalence and factors associated with vitamin B12 deficiency in elderly from Viçosa/MG, Brasil

Publicado: 2022-01-20 / http://dx.doi.org/

Trabajo Original: The relationship between vitamin B12 levels and electrocardiographic ventricular repolarization markers

Emre Yılmaz , Devrim Kurt , Aslı Vural , Ertan Aydın , Sencer Çamcı , Ercan Aydın

Publicado: 2021-12-13 / http://dx.doi.org/10.20960/nh.03995

Trabajo Original: The dietary risk factors on cancer patients receiving chemotherapy and correlation between serum vitamin D and B12 levels, depression and anxiety status

Mihrican Kacar , Nural Erzurum Alim

Publicado: 2022-11-13 / http://dx.doi.org/10.20960/nh.04530

Artículos más populares

Revisión: Ayuno intermitente: efectos en diversos escenarios clínicos

Introducción: los esquemas de ayuno intermitente (...

Publicado: 2023-05-24

Trabajo Original: Body mass index and risk of inflammatory breast disease: a Mendelian randomization study

Introduction: in previous studies, obesity was ide...

Publicado: 2023-04-22

Revisión: Relación entre la dieta, aspectos nutricionales y la calidad del sueño en población pediátrica

.La relación entre la dieta y el sueño ha sido esc...

Publicado: 2023-06-08

Una cookie o galleta informática es un pequeño archivo de información que se guarda en su navegador cada vez que visita nuestra página web. La utilidad de las cookies es guardar el historial de su actividad en nuestra página web, de manera que, cuando la visite nuevamente, ésta pueda identificarle y configurar el contenido de la misma en base a sus hábitos de navegación, identidad y preferencias. Las cookies pueden ser aceptadas, rechazadas, bloqueadas y borradas, según desee. Ello podrá hacerlo mediante las opciones disponibles en la presente ventana o a través de la configuración de su navegador, según el caso. En caso de que rechace las cookies no podremos asegurarle el correcto funcionamiento de las distintas funcionalidades de nuestra página web. Más información en el apartado “POLÍTICA DE COOKIES” de nuestra página web.