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Cognitive and Behavioral Correlates of Low Vitamin B₁₂ Levels in Elderly Patients With Progressive Dementia

Received July 27, 2001; revised January 16, 2002; accepted January 30, 2002. From the Departments of Psychiatry (EMW, BHM, MAB, AT, RAS, WK, SW, STD), Medicine (AT), Epidemiology (SW), Neurology (STD), University of Pittsburgh, Pittsburgh Pennsylvania; and the Geriatric Research Education and Clinical Center, Pittsburgh Veterans Administration Health Care System, Pittsburgh Pennsylvania (EMW, BHM); and Department of Psychiatry, Finch University of Health Sciences, Chicago Illinois (MQ). Address correspondence to Dr. Whyte, Western Psychiatric Institute and Clinic, Room 886-B, 3811 O'Hara Street, Pittsburgh PA 15213-2593. e-mail: whyteem{at}msx.upmc.edu

Vitamin B₁₂ deficiency is common in elderly persons, yet its role in dementia and psychiatric illness is unclear. The authors examined the relationship between vitamin B₁₂ serum levels and cognitive and neuropsychiatric symptoms in dementia. Community-dwelling elderly subjects (N=643) meeting NINCDS-ADRDA criteria for probable or possible Alzheimer disease (AD) underwent comprehensive neuropsychiatric evaluation and measurement of vitamin B₁₂ serum levels. Thirty-seven subjects (5.7%) had low B₁₂ serum levels (200 pcg/ml or less). Subjects with low B₁₂ levels were significantly older and had significantly lower scores on the Mini-Mental State Exam and higher scores on the Blessed Dementia Scale, but not a different pattern of cognitive or behavior disturbances compared with the normal-B₁₂ subjects. In AD, the prevalence of low vitamin B₁₂ serum levels is consistent with that found in community-dwelling elderly persons in general but is associated with greater overall cognitive impairment.

Key Words: Dementias (general) • Behavioral Correlates • Vitamin B12

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