scholarly journals Vitamin B12 supplementation and cognitive scores in geriatric patients having Mild Cognitive Impairment

2016 ◽  
Vol 6 (9) ◽  
pp. 578 ◽  
Author(s):  
Komal Chauhan ◽  
Aditika Agarwal
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Vitamin B12 ◽  
Neurological Disorders ◽  
Geriatric Patients ◽  
Serum Vitamin ◽  
The Elderly ◽  
Cognitively Impaired ◽  
Vitamin B12 Supplementation ◽  
Young Old

Background: The Neurodegenerative diseases are increasingly affecting the elderly with a severe impact on their brain health. There is a wide gap in supplementation based studies for increasing the cognition levels of the geriatric population especially in the developing countries like India, which are at extreme risk of developing neurological disorders. Vitamin B12 herein has caught much attention lately for improving the cognitive status. Literature has linked the possibility of alleviating neurological disorders in the elderly with effective vitamin B12 management. Abundant animal and human models have proved that supplementation of vitamin B12 is beneficial for the restoration of cognitive functions. Objective: To supplement vitamin B12 deficient mild cognitively impaired geriatric patients with injectable doses of vitamin B12 followed by impact evaluation. Methods: Screening of the mild cognitively impaired patients was carried out using the Mini-Mental State Examination and Yamaguchi Fox Pigeon Imitation test. Baseline information was elicited from the patients residing in urban Vadodara (a district in the state of Gujarat), India. This included socio-demographic, medical and drug history, anthropometric and physical activity pattern as well as biochemical parameters comprising of serum vitamin B12 and glycated haemoglobin profile. A sub-sample of 60 patients with mild cognitive impairment (MCI) demonstrating severe vitamin B12 deficiency were conveniently enrolled for injectable doses of Vitamin B12 in the dosage of 1,000 μg every day for one week, followed by 1,000 μg every week for 4 weeks & finishing with 1,000 μg for the remaining 4 months. Post six months intervention all the parameters were elicited. Results: Vitamin B12 supplementation resulted in a significant (p<0.001) improvement in the MMSE scores of the patients with a rise of 9.63% in the total patients. Gender-wise division also highlighted a significant increase (p<0.001) in the scores by 6.79% and 12.46% in overall males and females and a 10.20% and 8.24% rise for young-old (60-69 yrs) and old- old (70-85 yrs) categories, respectively. As a result, 27 patients progressed towards the category from the MCI state being assessed by MMSE scores. In the same manner, YGFPIT too demonstrated a 38% increase in normal with 35% males, 42% females, 41% young–old and 31% old-old moving to normal status. Thus, a total number of 28 patients progressed to the normal condition as per YGFPIT.Conclusion: Hence, vitamin B12 supplementation was found significantly effective in placing the serum vitamin B12 of MCI patients from the deficiency state to sufficient levels and in turn increased their performance in MMSE and YFPIT scores. Keywords: Mild Cognitive Impairment, vitamin B12, geriatrics, cognition

scholarly journals FOLATE AND SYNTHETIC FOLIC ACID INTAKE, SERUM B VITAMIN AND HOMOCYSTEINE CONCENTRATIONS, AND COGNITIVE IMPAIRMENT IN ELDERLY BRAZILIANS

2017 ◽  
pp. 1-8
Author(s):  
V. Ferri Ross Perucha ◽  
R. de Cássia de Aquino ◽  
N. Gaspareto ◽  
E.M. Guerra-Shinohara ◽  
P. Mendonça da Silva Amorim ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Folic Acid ◽  
Vitamin B12 ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Serum Vitamin ◽  
The Elderly ◽  
Acid Consumption ◽  
B12 Deficiency ◽  
State Examination

Background: An increased risk of cognitive decline in the elderly with B12 deficiency has been associated with excessive synthetic folic acid in food fortification and supplements. Objectives: To assess the dietary folate and folic acid intake from food fortification, as well as serum vitamin B12, folate, iron, and homocysteine concentrations among the elderly and their relationships with cognitive changes. Design: Cross-sectional, observational study. Setting and Participants: Community-dwelling elderly (N = 40), predominantly female (90%), with an average age of 69 years. Measurements: Dietary intake information was collected using four 24-hour dietary recalls, adjusted for iron and folic acid in fortified flour and supplements. Serum vitamin B12, B6, folate, iron, and homocysteine concentrations were determined. Cognitive function was assessed using the Mini-Mental State Examination, adjusted for educational level. Results: Possible serum vitamin B12 deficiency (<258 pmol/L) was present in 5% of the elderly participants, while 27.5% had possible functional deficiency (<400 pmol/L). No serum folate deficiency (<6.8 nmol/L) was observed; however, 15% had possible deficiency (<13.6 nmol/L), and 7.5% had supraphysiological levels. Hyperhomocysteinemia (≥15 µmol/L) was present in 65% of the sample. Almost half of the participants (47.5%) showed cognitive impairment. There were no significant relationships between the Mini-Mental State Examination results and the B12, folate, iron, and homocysteine concentrations. However, the participants with serum vitamin B12 levels <400 pmol/L tended to have poorer Mini-Mental State Examination scores, which were related to older age (P = 0.045) and changes in the oral cavity (P = 0.034). In addition, folic acid consumption was inversely related with serum vitamin B12 levels (P = 0.030). Macrocytosis was not observed. Conclusions: Although Mini-Mental State Examination-assessed cognitive impairment was not related with the investigated biochemical variables, increased folic acid consumption seems to have a negative impact on vitamin B12 metabolism; therefore, fortification may be contributing to functional disability and masking hematological signs in the elderly.

Easy Screening for Mild Alzheimer's Disease and Mild Cognitive Impairment from Elderly Speech

2018 ◽  
Vol 15 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Shohei Kato ◽  
Akira Homma ◽  
Takuto Sakuma
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Characteristic Curve ◽  
Linear Regression Analysis ◽  
Speech Sound ◽  
The Elderly ◽  
Speech Sounds ◽  
Mel Frequency Cepstral Coefficients

Objective: This study presents a novel approach for early detection of cognitive impairment in the elderly. The approach incorporates the use of speech sound analysis, multivariate statistics, and data-mining techniques. We have developed a speech prosody-based cognitive impairment rating (SPCIR) that can distinguish between cognitively normal controls and elderly people with mild Alzheimer's disease (mAD) or mild cognitive impairment (MCI) using prosodic signals extracted from elderly speech while administering a questionnaire. Two hundred and seventy-three Japanese subjects (73 males and 200 females between the ages of 65 and 96) participated in this study. The authors collected speech sounds from segments of dialogue during a revised Hasegawa's dementia scale (HDS-R) examination and talking about topics related to hometown, childhood, and school. The segments correspond to speech sounds from answers to questions regarding birthdate (T1), the name of the subject's elementary school (T2), time orientation (Q2), and repetition of three-digit numbers backward (Q6). As many prosodic features as possible were extracted from each of the speech sounds, including fundamental frequency, formant, and intensity features and mel-frequency cepstral coefficients. They were refined using principal component analysis and/or feature selection. The authors calculated an SPCIR using multiple linear regression analysis. Conclusion: In addition, this study proposes a binary discrimination model of SPCIR using multivariate logistic regression and model selection with receiver operating characteristic curve analysis and reports on the sensitivity and specificity of SPCIR for diagnosis (control vs. MCI/mAD). The study also reports discriminative performances well, thereby suggesting that the proposed approach might be an effective tool for screening the elderly for mAD and MCI.

scholarly journals Heterogeneity of Amyloid Binding in Cognitively Impaired Patients Consecutively Recruited from a Memory Clinic: Evaluating the Utility of Quantitative 18F-Flutemetamol PET-CT in Discrimination of Mild Cognitive Impairment from Alzheimer’s Disease and Other Dementias

2020 ◽  
pp. 1-14
Author(s):  
Yi-Wen Bao ◽  
Anson C.M. Chau ◽  
Patrick Ka-Chun Chiu ◽  
Yat Fung Shea ◽  
Joseph S.K. Kwan ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Amyloid Β ◽  
Standardized Uptake Value ◽  
Subjective Cognitive Decline ◽  
Cognitively Impaired ◽  
Memory Clinic ◽  
Pet Ct

Background: With the more widespread use of 18F-radioligand-based amyloid-β (Aβ) PET-CT imaging, we evaluated Aβ binding and the utility of neocortical 18F-Flutemetamol standardized uptake value ratio (SUVR) as a biomarker. Objective: 18F-Flutemetamol SUVR was used to differentiate 1) mild cognitive impairment (MCI) from Alzheimer’s disease (AD), and 2) MCI from other non-AD dementias (OD). Methods: 109 patients consecutively recruited from a University memory clinic underwent clinical evaluation, neuropsychological test, MRI and 18F-Flutemetamol PET-CT. The diagnosis was made by consensus of a panel consisting of 1 neuroradiologist and 2 geriatricians. The final cohort included 13 subjective cognitive decline (SCD), 22 AD, 39 MCI, and 35 OD. Quantitative analysis of 16 region-of-interests made by Cortex ID software (GE Healthcare). Results: The global mean 18F-Flutemetamol SUVR in SCD, MCI, AD, and OD were 0.50 (SD-0.08), 0.53 (SD-0.16), 0.76 (SD-0.10), and 0.56 (SD-0.16), respectively, with SUVR in SCD and MCI and OD being significantly lower than AD. Aβ binding in SCD, MCI, and OD was heterogeneous, being 23%, 38.5%, and 42.9% respectively, as compared to 100% amyloid positivity in AD. Using global SUVR, ROC analysis showed AUC of 0.868 and 0.588 in differentiating MCI from AD and MCI from OD respectively. Conclusion: 18F-Flutemetamol SUVR differentiated MCI from AD with high efficacy (high negative predictive value), but much lower efficacy from OD. The major benefit of the test was to differentiate cognitively impaired patients (either SCD, MCI, or OD) without AD-related-amyloid-pathology from AD in the clinical setting, which was under-emphasized in the current guidelines proposed by Amyloid Imaging Task Force.

scholarly journals Mild Cognitive Impairment in Clinical Practice: A Review Article

2018 ◽  
Vol 33 (8) ◽  
pp. 500-507 ◽  
Author(s):  
Sukanya Jongsiriyanyong ◽  
Panita Limpawattana
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Preventive Intervention ◽  
Lifestyle Modification ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Review Article ◽  
Subjective Cognitive Impairment ◽  
Rate Of Progression

The spectrum of cognitive decline in the elderly ranges from what can be classified as normal cognitive decline with aging to subjective cognitive impairment to mild cognitive impairment (MCI) to dementia. This article reviewed the up-to-date evidence of MCI including the diagnostic criteria of MCI due to Alzheimer’s disease, vascular cognitive impairment and MCI due to Parkinson disease, management and preventive intervention of MCI. There are various etiologies of MCI, and a large number of studies have been conducted to ascertain the practical modalities of preserving cognition in predementia stages. Lifestyle modification, such as aerobic exercise, is an approved modality to preserve cognitive ability and decrease the rate of progression to dementia, as well as being recommended for frailty prevention.

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