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Whether our elderly relatives need vitamin B12 or not,to keep their brain in good shape is still a matter ofdebate. Negative reports prevailed in the past, nowtimes are changing a bit.This is a positive report from Israel.I find it sharp and encouraging indeed...If only a few patients respond to a treatment, we haveto identify their 'size and shape', instead of throwingthe whole research in the garbage bin. Neuropsychology of vitamin B12 deficiency in elderly dementia patients and control subjects. [/b]Osimani A, Berger A, Friedman J, Porat-Katz BS, Abarbanel JM.Kaplan Hospital, Rehovot, Israel and the Department of Behavioral Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.Cobalamin deficiency may cause cognitive deficits and even dementia. In Alzheimer's disease, the most frequent cause of dementia in elderly persons, low serum levels of vitamin B12, may be misleading. The aim of this work was to characterize the cognitive pattern of B12 deficiency and to compare it with that of Alzheimer's disease. Nineteen patients with low levels of vitamin B12 were neuropsychologically evaluated before treatment and a year later. Results were compared with those of 10 healthy control subjects. Final results suggest that there is a different pattern in both diseases. Twelve elderly patients with dementia improved with treatment. Seven elderly demented patients did not improve; they deteriorated after 1 year although their levels of cobalamin were normal. Analysis of the initial evaluation showed that the 2 groups of patients had a different neuropsychological profile. The group that improved had initially more psychotic problems and more deficits in concentration, visuospatial performance, and executive functions. They did not show language problems and ideomotor apraxia, which were present in the second group. Their memory pattern was also different. These findings suggest that cobalamin deficiency may cause a reversible dementia in elderly patients. This dementia may be differentiated from that of Alzheimer's disease by a thorough neuropsychological evaluation.J Geriatr Psychiatry Neurol. 2005 Mar;18(1):33-8.http://content.answers.com/main/content/img/McGrawHill/Encyclopedia/images/CE734300FG0010.gif
Importance of vitamin B12 is being revisitedafter long years of criticism and hostility.Not a 'tsunami' effect like with vitamin D,only a correct re-evaluation of its qualities.This is one of many recent positive reports: Vitamin B12, folic acid, and the nervous system. Reynolds E.Institute of Epileptology, King's College, Denmark Hill Campus, Cutcombe Road, London, SE5 6PJ, UK. email@example.comThere are many reasons for reviewing the neurology of vitamin-B12 and folic-acid deficiencies together, including the intimate relation between the metabolism of the two vitamins, their morphologically indistinguishable megaloblastic anaemias, and their overlapping neuropsychiatric syndromes and neuropathology, including their related inborn errors of metabolism. Folates and vitamin B12 have fundamental roles in CNS function at all ages, especially the methionine-synthase mediated conversion of homocysteine to methionine, which is essential for nucleotide synthesis and genomic and non-genomic methylation. Folic acid and vitamin B12 may have roles in the prevention of disorders of CNS development, mood disorders, and dementias, including Alzheimer's disease and vascular dementia in elderly people.Lancet Neurol. 2006 Nov;5(11):949-60.Preventing Age-Related Cognitive DeclineBy Laurie Barclay, MD...Replacement of B vitamins in deficient individuals often improves short-term memory and language skills. Elderly subjects who are low in folic acid show impairment in both word recall and object recall, suggesting a vital role for folic acid in memory function in later life. Memory impairment in the elderly related to vitamin B12 deficiency can be reversed by vitamin B12 injections or supplements. High doses of vitamin B6 and folate reduce blood levels of homocysteine, a toxic buildup product linked to heart disease and cognitive impairment. In dementia patients with even mild deficiencies of vitamin B12 or folate, replacement can improve cognition, especially in those with elevated blood homocysteine levels. In a study of 76 elderly males, vitamin B6 was better than placebo in improving long-term information storage and retrieval.http://www.lef.org/magazine/mag2005/images/apr2005_cover_cognitive_04.jpgLife Extension Magazine - April 2005 http://www.lef.org/magazine/mag2005/apr2005_cover_cognitive_02.htm
Vitamin B12 deficiency could cause pernicious anemia and/or severe neurologic damage, psychotic behaviour and in rare cases irreversible blindness. I remember a report of few years ago about a young man left completely blind after a badly managed vegan diet.ikoDementia caused by vitamin B12 deficiency. Clinical case[Article in Spanish]Behrens MI, Diaz V, Vasquez C, Donoso A.Departamento de Neurologia y Neurocirugia, Hospital Clinico Universidad de Chile.Cyanocobalamin (vitamin B12) deficiency can cause polyneuropathy, myelopathy, blindness, confusion, psychosis and dementia. Nonetheless, its deficiency as the sole cause of dementia is infrequent. We report a 59 years old man with a 6 months history of progressive loss of memory, disorientation, apathy, paranoid delusions, gait difficulties with falls, and urinary incontinence. He had suffered a similar episode 3 years before, with a complete remission. On examination there was frontal type dementia with Korsakoff syndrome, a decrease in propioception and ataxic gait. Cerebrospinal fluid examination showed a protein of 0.42 g/L. Brain computed tomography showed sequelae of a frontal left trauma. Brain single photon computed tomography (SPECT) was normal. Complete blood count showed a macrocytic anemia with a hematocrit 29% and a mean corpuscular volume of 117 micron3.Plasma vitamin B12 levels were undetectable, erythrocyte folate levels were 3.9 ng/ml and plasma folate was normal. The myelogram showed megaloblastosis and the gastric biopsy showed atrophic gastritis. Treatment with parenteral B12 vitamin and folic acid reverted the symptoms, with normalization of the neuropsychological tests and reintegration to work.Rev Med Chil. 2003 Aug;131(:915-9.
I forgot to explain how vitamin B12 deficiency could develop even on a regular diet.Gastric atrophy leads to impaired production of a special protein (Intrinsic Factor) that binds B12 and allows its absorption in the intestine.Liver can stock large amounts of B12 enough for approx. 6 months.So if the stomach stops making IF, after 6m on a regular diet vitamin B12 deficiency becomes evident (to whom can diagnose it on the spot!). Large amounts of B12 taken by mouth allow the intestine to absorb enough vitamin anyway. But in case of severe deficiency, parenteral administration for a few days is recommended.byeiko
Vitamin D Deficiency Is Associated With Low Mood and Worse Cognitive Performance in Older Adults.Wilkins CH, Sheline YI, Roe CM, Birge SJ, Morris JC.Dept.Med.Div.Geriatrics and Nutritional Science, Alzheimer's Disease Research Center, the Dept.Psychiatry, Dept.Neurol., and the Div.Biostatistics, Washington Univ.School of Medicine, St. Louis, MO.Background: Vitamin D deficiency is common in older adults and has been implicated in psychiatric and neurologic disorders. This study examined the relationship among vitamin D status, cognitive performance, mood, and physical performance in older adults.Methods: A cross-sectional group of 80 participants, 40 with mild Alzheimer disease (AD) and 40 nondemented persons, were selected from a longitudinal study of memory and aging. Cognitive function was assessed using the Short Blessed Test (SBT), Mini-Mental State Exam (MMSE), Clinical Dementia Rating (CDR; a higher Sum of Boxes score indicates greater dementia severity), and a factor score from a neuropsychometric battery; mood was assessed using clinician's diagnosis and the depression symptoms inventory. The Physical Performance Test (PPT) was used to measure functional status. Serum 25-hydroxyvitamin D levels were measured for all participants.Results: The mean vitamin D level in the total sample was 18.58 ng/mL (standard deviation: 7.59); 58% of the participants had abnormally low vitamin D levels defined as less than 20 ng/mL. After adjusting for age, race, gender, and season of vitamin D determination, vitamin D deficiency was associated with presence of an active mood disorder (odds ratio: 11.69, 95% confidence interval: 2.04-66.86; Wald chi(2) = 7.66, df = 2, p = 0.022). Using the same covariates in a linear regression model, vitamin D deficiency was associated with worse performance on the SBT (F = 5.22, df = [2, 77], p = 0.044) and higher CDR Sum of Box scores (F = 3.20, df = [2, 77], p = 0.047) in the vitamin D-deficient group. There was no difference in performance on the MMSE, PPT, or factor scores between the vitamin D groups.Conclusions: In a cross-section of older adults, vitamin D deficiency was associated with low mood and with impairment on two of four measures of cognitive performance.Am J Geriatr Psychiatry. 2006 Dec;14(12):1032-1040.
Initially in dementia, which begins benignly over months and years, there is memory loss for recent events such as stoves being left on, keys being misplaced, conversations forgotten. Later, people begin to get lost while driving roads that they once knew very well, and questions must be repeated because the questions and answers are quickly forgotten. The long-ago memories are retained and dwelled upon. Personality changes occur, and the person may manifest changes that are the complete opposite from their previous personality. Poor judgement and impulse control often go hand-in-hand. They may speak crudely, make lewd gestures and display their genitals.The intellectual functions begin to deteriorate, with the patient having trouble naming objects, difficulties understanding language, and their speech can become stereotyped, slow, vague and filled with irrelevant details and they are unable to concentrate and follow a conversation and determine what is relevant and what is not.They begin to have difficulty with motor tasks such as drawing a house, handling money, using tools to cook, assemble blocks. Patients often deny these problems vigorously, or become ashamed of them, and enter a phase of depression, anxious, and demoralized. They may then begin to show emotional incontinence: respond to situations inappropriately by crying, laughing, hostility, and immobility at inappropriate times. They may confabulate stories to make up for lost memories to conceal the degree of memory loss. Upon examination, these patients generally move slowly and deliberately or fidget, looking glum, bored or tense. On the other side, they may portray a mood of jocularity in which they make inappropriate remarks to members of the opposite sex.
Sorry I haven't been able to keep up in here. We've had a very tense 3 days.He finally passed away in the early hours of this morning....I won't be able to log in here for a while but I'll be checking emails. Thanks friends