Randomized trial of the effect of supplementation on the cognitivefunction of older people with subnormal cobalamin levels
T. Kwok
Bok Engelsk 1998
| Utgitt | 1998
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| Omfang | Side 611- 616
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| Opplysninger | Background. Low serum cobalamin levels are often found in apparentlynormal older subjects. A major worry of leaving cobalamin deficiencyuntreated is that it may lead to subtle deterioration in cognitivefunction.Objectives. To investigate the effect of supplementation on thecognitive function of older people with cobalamin deficiency by arandomized trial.Methods. Fifty Chinese subjects more than 60 years old with serumcobalamin level < 120 pmol/l were randomized into supplement andcontrol groups. Fasting serum methylmalonic acid levels (MMA) weremeasured. A battery of neuropsychological tests was administered. Thesupplement group received intramuscular cyanocobalamin injections,while the control group received no intervention. They were followedup at around 4 months.Results. 78% of the subjects had raised MMA, indicating metaboliccobalamin deficiency. Supplemented subjects improved in performanceIQ, but the amount of improvement was not significantly more thanthat of control subjects. Moreover, the supplement group fared worsethan the control group at follow-up in some motor function scores.Three out of seven demented subjects had improvement in Mini-MentalState Examination scores, but there was no consistent improvement inother neuropsychological scores.Conclusions. This study suggested that cobalamin deficiency did notinvariably cause cognitive impairment in older people. There remainthe possibilities that cobalamin deficiency causes cognitiveimpairment or exacerbates coexisting dementia in some older people.(C) 1998 John Wiley & Sons, Ltd.
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