E Bozoglu, AT Isik, H Doruk, S Kilic

The effects of early vitamin B12 replacement therapy on the cognitive and functional status of elderly subjects

Objective: The aim of this study was to examine the effects of early vitamin B12 replacement on cognitive and functional status in elderly subjects with low vitamin B12 levels by using neuropsychological assessment scales.

Methods: A total of 327 elderly patients with low vitamin B12 levels (<400 pg/ml) were evaluated. While 116 of 327 patients had cognitive impairment, 211 subjects did not. All patients were prescribed 1000 micrograms cyanocobalamin intramuscularly every week for 1 month, then monthly for 5 months. The mini-mental status examination (MMSE), clock drawing test, activities of daily living, and instrumental activities of daily living scales were applied to all patients at baseline and 6 month.

Results: At the 6-month evaluation it was found that 120 subjects have received only 1 dose or no vitamin B12 supplementation for various reasons. While their complete blood count parameters were stable; vitamin B12 levels, cognitive and functional scales’ scores worsened significantly (p values <0.05). However, 207 subjects who had received 2 or more doses of B12 supplementation, showed statistically significant increase in their vitamin B12 levels, mini-mental state examination, clock drawing scales’ scores (p values <0.05) and preservation in their activities of daily living and instrumental activities of daily living scales’ scores.

Conclusion: Testing and close follow-up for vitamin B12 levels and early supplementation of vitamin B12 levels <400 pg/ml in geriatric subjects seem to improve the cognitive status and maintain the functional status.(Bulletin of Clinical Psychopharmacology Volume 20, Issue 2, 2010)

Keywords : Vitamin B12, cognitive function, functional status, elderly