What are the First Signs and Symptoms of Dementia?

2017 ◽  
Author(s):  
Paul B. Rosenberg
Keyword(s):  
Cognitive Impairment ◽  
Vitamin B12 Deficiency ◽  
Signs And Symptoms ◽  
Amyloid Pet ◽  
Daily Lives ◽  
Increased Risk ◽  
Neurological Exam ◽  
Prodromal Alzheimer’S Disease ◽  
B12 Deficiency ◽  
Near Term

Mild cognitive impairment (MCI) is a syndrome where persons have mild cognitive complaints and deficits on exam but are still functioning well in their daily lives. Persons with MCI are at markedly increased risk of developing dementia in the near-term and thus are an important target for preventive interventions. In the office it is crucial to take a careful history and to have an informant (usually a family member). Prodromal Alzheimer’s disease is typified by problems in short-term recall likely due to hippocampal dysfunction, and depression and anxiety are relatively common. Brief cognitive tests such as the Mini-Mental State Exam (MMSE) or Montreal Cognitive Assessment (MoCA) are useful. A thorough physical/neurological exam and laboratory screening are important for ruling out other neurologic illnesses such as Parkinsons’ or stroke and for screening for treatable causes of cognitive impairment such as hypothyroidism or vitamin B12 deficiency. Biomarkers are gradually becoming more useful for diagnosis including MRI and amyloid PET scan.

scholarly journals Association between Inflammatory Conditions and Alzheimer’s Disease Age of Onset in Down Syndrome

2021 ◽  
Vol 10 (14) ◽  
pp. 3116
Author(s):  
Florence Lai ◽  
Nathaniel Mercaldo ◽  
Cassandra M. Wang ◽  
Giovi G. Hersch ◽  
Herminia Diana Rosas
Keyword(s):  
Down Syndrome ◽  
Age Of Onset ◽  
Vitamin B12 Deficiency ◽  
Inflammatory Conditions ◽  
Increased Risk ◽  
Wide Range ◽  
High Prevalence ◽  
Autoimmune Conditions ◽  
B12 Deficiency ◽  
The Relationship

Adults with Down syndrome (DS) have an exceptionally high prevalence of Alzheimer disease (AD), with an earlier age of onset compared with the neurotypical population. In addition to beta amyloid, immunological processes involved in neuroinflammation and in peripheral inflammatory/autoimmune conditions are thought to play important roles in the pathophysiology of AD. Individuals with DS also have a high prevalence of autoimmune/inflammatory conditions which may contribute to an increased risk of early AD onset, but this has not been studied. Given the wide range in the age of AD onset in those with DS, we sought to evaluate the relationship between the presence of inflammatory conditions and the age of AD onset. We performed a retrospective study on 339 adults with DS, 125 who were cognitively stable (CS) and 214 with a diagnosis of AD. Data were available for six autoimmune conditions (alopecia, celiac disease, hypothyroidism, psoriasis, diabetes and vitamin B12 deficiency) and for one inflammatory condition, gout. Gout was associated with a significant delay in the age of AD onset by more than 2.5 years. Our data suggests that inflammatory conditions may play a role in the age of AD onset in DS. Further studies are warranted.

Oral signs and symptoms in patients with undiagnosed vitamin B12 deficiency

1995 ◽  
Vol 24 (10) ◽  
pp. 468-470 ◽  
Author(s):  
E. Anne Field ◽  
Janet A. Speechley ◽  
F. R. Rugman ◽  
E. Varga ◽  
W. R. Tyldesley
Keyword(s):  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Signs And Symptoms ◽  
B12 Deficiency

scholarly journals Methylmalonic acid, vitamin B12, renal function, and risk of all-cause mortality in the general population: results from the prospective Lifelines-MINUTHE study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ineke J. Riphagen ◽  
Isidor Minović ◽  
Dion Groothof ◽  
Adrian Post ◽  
Manfred L. Eggersdorfer ◽  
...  
Keyword(s):  
Renal Function ◽  
Vitamin B12 ◽  
Methylmalonic Acid ◽  
Vitamin B12 Deficiency ◽  
Endogenous Production ◽  
Increased Risk ◽  
B12 Deficiency ◽  
Study Population ◽  
Age And Sex

Abstract Background Methylmalonic acid (MMA) is best known for its use as a functional marker of vitamin B12 deficiency. However, MMA concentrations not only depend on adequate vitamin B12 status, but also relate to renal function and endogenous production of propionic acid. Hence, we aimed to investigate to what extent variation in MMA levels is explained by vitamin B12 and eGFR and whether MMA levels are associated with mortality if vitamin B12 and eGFR are taken into account. Methods A total of 1533 individuals (aged 60–75 years, 50% male) were included from the Lifelines Cohort and Biobank Study. Individuals were included between 2006 and 2013, and the total follow-up time was 8.5 years. Results Median [IQR] age of the study population was 65 [62–69] years, 50% was male. At baseline, median MMA concentration was 170 [138–216] nmol/L, vitamin B12 290 [224–362] pmol/L, and eGFR 84 [74–91] mL/min/1.73 m2. Log2 vitamin B12, log2 eGFR, age, and sex were significantly associated with log2 MMA in multivariable linear regression analyses (model R2 = 0.22). After a total follow-up time of 8.5 years, 72 individuals had died. Log2 MMA levels were significantly associated with mortality (hazard ratio [HR] 1.67 [95% CI 1.25–2.22], P < 0.001). Moreover, we found a significant interaction between MMA and eGFR with respect to mortality (Pinteraction < 0.001). Conclusions Only 22% of variation in MMA levels was explained by vitamin B12, eGFR, age, and sex, indicating that a large part of variation in MMA levels is attributable to other factors (e.g., catabolism, dietary components, or gut microbial production). Higher MMA levels are associated with an increased risk for mortality, independent of vitamin B12, eGFR, and sex. This association was more pronounced in individuals with impaired renal function.

A Case of Vitamin B12 Deficiency With Various Psychiatric Symptoms and Cognitive Impairment

2020 ◽  
Vol 22 (1) ◽  
Author(s):  
Keitaro Kimoto ◽  
Bunta Shibasaki ◽  
Norio Tamura ◽  
Yuki Takahashi ◽  
Mizuki Maehara ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Vitamin B12 ◽  
Psychiatric Symptoms ◽  
Vitamin B12 Deficiency ◽  
B12 Deficiency

A Japanese Multicenter Study on PET and Other Biomarkers for Subjects with Potential Preclinical and Prodromal Alzheimer’s Disease

2021 ◽  
pp. 1-8
Author(s):  
M. Senda ◽  
K. Ishii ◽  
K. Ito ◽  
T. Ikeuchi ◽  
H. Matsuda ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Multicenter Study ◽  
Fdg Pet ◽  
Structural Mri ◽  
Amyloid Pet ◽  
Positron Emission ◽  
Prodromal Alzheimer’S Disease ◽  
T Tau

BACKGROUND: PET (positron emission tomography) and CSF (cerebrospinal fluid) provide the “ATN” (Amyloid, Tau, Neurodegeneration) classification and play an essential role in early and differential diagnosis of Alzheimer’s disease (AD). OBJECTIVE: Biomarkers were evaluated in a Japanese multicenter study on cognitively unimpaired subjects (CU) and early (E) and late (L) mild cognitive impairment (MCI) patients. MEASUREMENTS: A total of 38 (26 CU, 7 EMCI, 5 LMCI) subjects with the age of 65-84 were enrolled. Amyloid-PET and FDG-PET as well as structural MRI were acquired on all of them, with an additional tau-PET with 18F-flortaucipir on 15 and CSF measurement of Aβ1-42, P-tau, and T-tau on 18 subjects. Positivity of amyloid and tau was determined based on the positive result of either PET or CSF. RESULTS: The amyloid positivity was 13/38, with discordance between PET and CSF in 6/18. Cortical tau deposition quantified with PET was significantly correlated with CSF P-tau, in spite of discordance in the binary positivity between visual PET interpretation and CSF P-tau in 5/8 (PET-/CSF+). Tau was positive in 7/9 amyloid positive and 8/16 amyloid negative subjects who underwent tau measurement, respectively. Overall, a large number of subjects presented quantitative measures and/or visual read that are close to the borderline of binary positivity, which caused, at least partly, the discordance between PET and CSF in amyloid and/or tau. Nine subjects presented either tau or FDG-PET positive while amyloid was negative, suggesting the possibility of non-AD disorders. CONCLUSION: Positivity rate of amyloid and tau, together with their relationship, was consistent with previous reports. Multicenter study on subjects with very mild or no cognitive impairment may need refining the positivity criteria and cutoff level as well as strict quality control of the measurements.

Cognitive impairment and vitamin B12: a review

2012 ◽  
Vol 24 (4) ◽  
pp. 541-556 ◽  
Author(s):  
Eileen Moore ◽  
Alastair Mander ◽  
David Ames ◽  
Ross Carne ◽  
Kerrie Sanders ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Vitamin B12 ◽  
Neurodegenerative Disease ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Small Subset ◽  
High Dose ◽  
Serum Homocysteine ◽  
B12 Deficiency ◽  
Potential Impact

ABSTRACTBackground: This review examines the associations between low vitamin B12 levels, neurodegenerative disease, and cognitive impairment. The potential impact of comorbidities and medications associated with vitamin B12 derangements were also investigated. In addition, we reviewed the evidence as to whether vitamin B12 therapy is efficacious for cognitive impairment and dementia.Methods: A systematic literature search identified 43 studies investigating the association of vitamin B12 and cognitive impairment or dementia. Seventeen studies reported on the efficacy of vitamin B12 therapy for these conditions.Results: Vitamin B12 levels in the subclinical low-normal range (<250 ρmol/L) are associated with Alzheimer's disease, vascular dementia, and Parkinson's disease. Vegetarianism and metformin use contribute to depressed vitamin B12 levels and may independently increase the risk for cognitive impairment. Vitamin B12 deficiency (<150 ρmol/L) is associated with cognitive impairment. Vitamin B12 supplements administered orally or parenterally at high dose (1 mg daily) were effective in correcting biochemical deficiency, but improved cognition only in patients with pre-existing vitamin B12 deficiency (serum vitamin B12 levels <150 ρmol/L or serum homocysteine levels >19.9 μmol/L).Conclusion: Low serum vitamin B12 levels are associated with neurodegenerative disease and cognitive impairment. There is a small subset of dementias that are reversible with vitamin B12 therapy and this treatment is inexpensive and safe. Vitamin B12 therapy does not improve cognition in patients without pre-existing deficiency. There is a need for large, well-resourced clinical trials to close the gaps in our current understanding of the nature of the associations of vitamin B12 insufficiency and neurodegenerative disease.

scholarly journals Keeping a clear head with vitamin B12

2010 ◽  
Vol 32 (6) ◽  
pp. 20-24
Author(s):  
Elena Kazamia ◽  
Katherine E. Helliwell ◽  
Alison G. Smith
Keyword(s):  
Vitamin B12 ◽  
Dairy Products ◽  
Vitamin B12 Deficiency ◽  
Physiological Role ◽  
Pernicious Anaemia ◽  
Increased Risk ◽  
B12 Deficiency ◽  
The Subject ◽  
Enzyme Cofactors ◽  
Essential Enzyme

Vitamins are vital organic micronutrients that are required in our diet because they provide essential enzyme cofactors, and animals have dispensed with the ability to synthesize them. Vitamin B12, or cobalamin, is the most complex of the vitamins, and the elucidation of its physiological role, its structure and its biosynthetic pathways have been the subject of impressive scientific endeavours over the years. Vitamin B12 deficiency leads to increased risk of cardiovascular disease, neurological symptoms and, in the most serious cases, pernicious anaemia. Cobalamin is synthesized only by prokaryotes, so we obtain it second-hand by eating other organisms that have accumulated the vitamin in their tissues. The richest dietary sources are liver, dairy products and also algae, many of which are like animals in that they require an exogenous supply of the vitamin for growth.

scholarly journals P2-040: VITAMIN B12 SUPPLEMENTATION IMPROVES HYPERHOMOCYSTEINEMIA AND COGNITIVE IMPAIRMENT IN PATIENTS WITH VITAMIN B12 DEFICIENCY

2019 ◽  
Vol 15 ◽  
pp. P586-P586
Author(s):  
Asako Ueno ◽  
Tadanori Hamano ◽  
Soichi Enomoto ◽  
Norimichi Shirafuji ◽  
Miwako Nagata ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
B12 Deficiency ◽  
Vitamin B12 Supplementation
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