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Reevaluating Vitamin B12 Needs for Cognitive Health in Older Adults
Meeting the minimum requirement for vitamin B12 is essential for producing DNA, red blood cells, and nerve tissue; however, recent findings suggest that simply achieving this threshold may not be adequate for older adults. Insufficient levels of B12 could potentially heighten the risk of cognitive challenges.
A study conducted by researchers at UC San Francisco revealed that older adults, even those classified as healthy, displayed neurological and cognitive impairments despite having B12 concentrations within the established normal range. The research indicated that lower B12 levels corresponded with increased damage to the brain’s white matter—the area responsible for facilitating communication between different brain regions—and revealed significant impairments in cognitive and visual processing speeds when compared to individuals with higher B12 concentrations.
The study findings were reported in the Annals of Neurology on February 10.
Dr. Ari J. Green, the senior author and a faculty member in the Departments of Neurology and Ophthalmology at UCSF, emphasized that these outcomes prompt a reconsideration of existing vitamin B12 guidelines. “Historical assessments for healthy B12 levels may not account for subtle functional changes that can influence individuals who do not present clear symptoms,” stated Green. He highlighted that traditional deficiencies are often linked to a specific type of anemia and advocated for redefining B12 deficiency to include functional biomarkers to facilitate earlier detection and cognitive decline prevention.
Impact of Low B12 Levels on Cognitive Function
The study involved 231 participants, all healthy and with no indications of dementia or mild cognitive impairment, averaging 71 years of age. Participants were recruited through the Brain Aging Network for Cognitive Health (BrANCH) study based at UCSF.
Despite having average blood B12 levels of 414.8 pmol/L—substantially above the U.S. minimum requirement of 148 pmol/L—when adjusted for variables such as age, sex, education, and cardiovascular health, the study highlighted that the biologically active component of B12 presented a more accurate gauge of the vitamin’s effectiveness in the body. Participants with diminished active B12 showed slowed cognitive processing speeds, which were especially prominent among older individuals. These participants also faced significant delays in responding to visual stimuli, suggesting a broader impairment in brain processing ability.
Magnetic resonance imaging (MRI) revealed a greater number of lesions in the white matter of participants, raising concerns regarding possible connections to cognitive decline, dementia, or stroke.
Wider Implications for Vitamin B12 Deficiency
While this study focused on older adults, co-first author Alexandra Beaudry-Richard, who is pursuing her doctorate in research and medicine at UCSF and the University of Ottawa, noted that the implications of lower B12 levels might extend beyond this demographic. “These findings suggest that inadequate B12 could affect cognitive function more significantly than currently understood, possibly impacting a wider segment of the population,” she stated.
Beaudry-Richard stressed the importance of reevaluating B12 deficiency definitions in clinical practice. “Healthcare providers should consider recommending supplementation for older adults experiencing neurological symptoms, even if their levels appear normal,” she advised. She concluded by calling for further research into the biological mechanisms behind B12 insufficiency, as it could emerge as a preventable factor in cognitive decline.
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