Dementia and subnormal levels of vitamin B-12: Effects of replacement therapy on dementia
S. Teunisse
Bok Engelsk 1996
| Utgitt | 1996
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| Omfang | Side 522- 529
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| Opplysninger | Routine determination of serum vitamin B-12 levels is generallyrecommended as part of the screening of demented patients, based onthe notion that vitamin B-12 deficiency is one of the causes ofreversible dementia. We studied the effects of vitamin B-12replacement therapy in a prospective longitudinal study at a memoryclinic, with special emphasis on assessment of severity of dementia:not only cognitive deterioration, but also disability in theactivities of daily life, behavioural problems, and the burdenexperienced by the caregiver were examined using instruments ofproven validity. In a series of 170 consecutive patients withdementia, subnormal serum vitamin B-12 levels were found in 26 cases(15%): ail but one fulfilled diagnostic criteria for possibleAlzheimer's disease. Cobalamin supplementation was given to allpatients and the effect was evaluated after 6 months. When the sizeand pattern of individual change scores, and the mean change scoreson all instruments were taken into account, functioning afterreplacement therapy was not improved. When change scores of treatedpatients were compared with those of patients with Alzheimer'sdisease (n = 69), vitamin B-12 replacement did not result in slowingof the progression of dementia. Contrary to widely accepted beliefs,subnormal serum vitamin B-12 levels are not a (quantitatively)important cause of reversible dementia.
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