Elderly with memory problems could be protected from cognition with B Vitamins
Further results from an Oxford University study in 2010 were suggestive that mental decline in some elderly people with mild memory problems (mild cognitive impairment [MCI]) can be impeded by B vitamins.
This effect is more evident in participants with high blood levels of an amino acid, homocysteine. However, confirmation of such a result will necessitate larger trials in this population in order to determine whether progression to Alzheimer’s can be arrested with B vitamins.
The International Journal of Geriatric Psychiatry has published the findings.
While nearly one in six elderly people (70+) suffer from MCI and experience problems with memory, language, or other mental functions, these problems do not interfere to an extent that hampers daily life.
Within five years of diagnosis, nearly 50% of people with MCI develop dementia, mainly Alzheimer’s.
High blood homocysteine levels are associated with an increased Alzheimer’s risk, and blood homocysteine levels are controlled by the B vitamins folic acid, vitamin B6 and vitamin B12.
The team of researchers at Oxford University embarked upon establishing whether brain shrinkage (atrophy) observed in MCI could be impeded by administering high doses of B vitamins taken as daily tablets. Results published in the journal PLoS ONE in September last year revealed that compared to people on placebo, those taking B vitamins displayed a reduced rate of brain shrinkage.
A set of standard, validated tests of cognitive and clinical status were also completed by participants as part of the trial. The findings should be treated with more caution because these outcome measures in the study are secondary which implies that the trial was not primarily designed to inspect these measures or have adequate statistical credibility to investigate the differences between treatment groups.
Around 266 people with MCI over the age of 70 were recruited for the two-year, double-blind clinical trial. The participants of the group were randomly assigned to one of the 2 study arms: either a daily dose of vitamins comprising 0.8 mg folic acid, 0.5 mg vitamin B12, and 20 mg vitamin B6, or a placebo pill.
Study Co-lead, Prof. David Smith of Oxford University, said that “These are high doses of the B vitamins that could not be obtained from a normal diet or standard supplements and should be treated like a drug.”
Participants with high blood homocysteine levels showed statistically significant benefits with B vitamin treatment while almost all the cognitive tests showed no overall difference between participants on placebo and those receiving B vitamins.
During the trial period of 2 years, it was found that compared to participants on placebo, 50% of the participants with the highest homocysteine levels that received the B vitamins showed a significantly less decline in a range of tests of cognitive performance.
Additionally, at the end of two years it was found that compared to participants on placebo, quarter of the participants with the very highest homocysteine levels treated with B vitamins showed more improvement on a clinical rating of dementia.
“The striking parallel effect of B vitamins in slowing brain atrophy and at the same time reducing cognitive decline is consistent with a disease-modifying effect of this treatment,” said David Smith of the Department of Pharmacology and Founding Director of OPTIMA, Oxford University.
Neuropsychologist at OPTIMA in the Nuffield Department of Medicine, Dr Celeste de Jager, said that “These results are very promising for older people with mild memory problems. We hope to be funded to do a large scale trial, UK-wide, to confirm our results, and to determine if we can slow progression to dementia for those with MCI. We hope the public will be interested in joining our research project.’’
Prof. Smith added that “Should our findings be replicated in larger trials, in future years you could see people coming into GP surgeries who are diagnosed with MCI being prescribed B vitamins at high doses if they have high homocysteine levels. That is how we see it. It won’t be people with vague worries aboutmemory problems buying standard vitamin supplements over the counter at health stores.”
Chief Executive of Alzheimer’s Research UK and co-funder of the study, Rebecca Wood, said that
“These are further encouraging findings for B vitamins, but without large scale trials, we won’t know for sure how protective they might be against mental decline for elderly people. People should speak to their doctor before embarking on any vitamin plan.”
“Follow up clinical trials must have a particular emphasis on establishing whether B vitamins could head off conversion from MCI to Alzheimer’s.”
“Research is the only answer to dementia, the greatest medical challenge of our time. Unless we invest in research from the lab bench all the way to large scale trials, we will fail the many thousands of people set to develop dementia in the next generation.”
The trial was supported by grants from Charles Wolfson Charitable Trust, Medical Research Council, Alzheimer’s Research UK, Henry Smith Charity, Thames Valley Dementias and Neurodegenerative Diseases Research Network of the National Institute for Health Research, John Coates Charitable Trust, Sidney and Elizabeth Corob Charitable Trust, and Meda AB/Recip AB, who also donated the vitamin (TrioBe+) and placebo tablets.
Alzheimer’s Research UK