Vitamin Status and Cognitive Function in a Long-term Care Population

Overview

Journal BMC Geriatr

Publisher Biomed Central

Specialty Geriatrics

Date 2005 Dec 15

PMID 16351716

Citations 8

Authors

Lina Paulionis

Sheri-Lynn Kane

Kelly A Meckling

Affiliations

Soon will be listed here.

Abstract

Background: Ageing can be associated with poor dietary intake, reduced nutrient absorption, and less efficient utilization of nutrients. Loss of memory and related cognitive function are also common among older persons. This study aimed to measure the prevalence of inadequate vitamin status among long-term care patients and determine if an association exists between vitamin status and each of three variables; cognitive function, vitamin supplementation, and medications which alter gastric acid levels.

Methods: Seventy-five patients in a long-term care hospital in Guelph, Ontario were recruited to a cross-sectional study. 47 were female and the mean age was 80.7 (+/-11.5) years, ranging from 48 to 100 years. Blood was used to measure levels of vitamins B12 (cobalamin), B6 (pyridoxal-5'-phosphate/PLP), erythrocyte folate, vitamin B3 (niacin) and homocysteine (Hcy). The Standardized Mini-Mental State Examination (SMMSE) was administered to measure cognitive function. A list of medications and vitamin supplementation for each patient was provided by the pharmacy.

Results: The prevalence of low vitamin (B12, B6, erythrocyte folate, niacin) or high metabolite (homocysteine) levels among 75 patients were as follows: B12 <148 pmol/L in 5/75 (6.7%); B12 between 148 and 221 pmol/L in 26/75 (34.7%); B6 <or=30 nmol/L in 4/75 (5.3%); erythrocyte folate <370 nmol/L in 1/75 (1.3%); niacin ratio <or=1 in 20/75 (26.7%); homocysteine >13.3 micromol/L in 31/75 (41.3%). There was no significant difference among residents grouped into marked (n = 44), mild (n = 14), or normal (n = 9) cognitive function when evaluating the effect of vitamin status. There were no significant differences in mean B12 and homocysteine levels between users and non-users of drug therapy (Losec, Zantac, or Axid). Compared to vitamin supplement non-users, supplemented residents had significantly higher mean B12 (p < 0.0001) and erythrocyte folate (p < 0.05) concentrations and significantly lower mean homocysteine (p < 0.01) levels; 229.1 versus 423.6 pmol/L for B12, 882.9 versus 1043.6 nmol/L for erythrocyte folate and 14.4 versus 12.0 micromol/L for homocysteine.

Conclusion: Given the prevalence data on vitamin status in this sample population, the possible benefits of vitamin supplementation should be considered in clinical intervention studies using these populations of elderly.

Citing Articles

Regulation of and challenges in targeting NAD metabolism.

Migaud M, Ziegler M, Baur J Nat Rev Mol Cell Biol. 2024; 25(10):822-840.

PMID: 39026037 DOI: 10.1038/s41580-024-00752-w.

Exercise training upregulates intracellular nicotinamide phosphoribosyltransferase expression in humans: a systematic review with meta-analysis.

Sun X, Su L, Bu T, Zhang Y Front Public Health. 2023; 11:1287421.

PMID: 37954044 PMC: 10639164. DOI: 10.3389/fpubh.2023.1287421.

Association between dietary niacin intake and cognitive function in the elderly: Evidence from NHANES 2011-2014.

Shen X, Yang L, Liu Y, Jiang L, Huang J Food Sci Nutr. 2023; 11(8):4651-4664.

PMID: 37576033 PMC: 10420858. DOI: 10.1002/fsn3.3428.

Identification of Genetic Variations in the NAD-Related Pathways for Patients with Major Depressive Disorder: A Case-Control Study in Taiwan.

Chen D, Cheng S, Chen T, Chang J, Hwang B, Chang H J Clin Med. 2022; 11(13).

PMID: 35806906 PMC: 9267440. DOI: 10.3390/jcm11133622.

Alpha-Amino-Beta-Carboxy-Muconate-Semialdehyde Decarboxylase Controls Dietary Niacin Requirements for NAD Synthesis.

Palzer L, Bader J, Angel F, Witzel M, Blaser S, McNeil A Cell Rep. 2018; 25(5):1359-1370.e4.

PMID: 30380424 PMC: 9805792. DOI: 10.1016/j.celrep.2018.09.091.

References

Carmel R, Green R, Jacobsen D, Rasmussen K, Florea M, Azen C . Serum cobalamin, homocysteine, and methylmalonic acid concentrations in a multiethnic elderly population: ethnic and sex differences in cobalamin and metabolite abnormalities. Am J Clin Nutr. 1999; 70(5):904-10. DOI: 10.1093/ajcn/70.5.904. View

Russell R . The aging process as a modifier of metabolism. Am J Clin Nutr. 2000; 72(2 Suppl):529S-32S. DOI: 10.1093/ajcn/72.2.529S. View

Diaz-Arrastia R . Homocysteine and neurologic disease. Arch Neurol. 2000; 57(10):1422-7. DOI: 10.1001/archneur.57.10.1422. View

Matthews F, Dening T . Prevalence of dementia in institutional care. Lancet. 2002; 360(9328):225-6. DOI: 10.1016/S0140-6736(02)09461-8. View

Rose C, Gyorgy P, Butler M, Andres R, Norris A, SHOCK N . Age differences in vitamin B6 status of 617 men. Am J Clin Nutr. 1976; 29(8):847-53. DOI: 10.1093/ajcn/29.8.847. View

Gartler S, Hornung S, Motulsky A . Effect of chronologic age on induction of cystathionine synthase, uroporphyrinogen I synthase, and glucose-6-phosphate dehydrogenase activities in lymphocytes. Proc Natl Acad Sci U S A. 1981; 78(3):1916-9. PMC: 319246. DOI: 10.1073/pnas.78.3.1916. View

Goodwin J, Goodwin J, Garry P . Association between nutritional status and cognitive functioning in a healthy elderly population. JAMA. 1983; 249(21):2917-21. View

Raskind M . Nutrition and cognitive function in the elderly. JAMA. 1983; 249(21):2939-40. View

Clissold S . Omeprazole. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in peptic ulcer disease and Zollinger-Ellison syndrome. Drugs. 1986; 32(1):15-47. DOI: 10.2165/00003495-198632010-00002. View

10.

Krasinski S, Russell R, SAMLOFF I, Jacob R, Dallal G, MCGANDY R . Fundic atrophic gastritis in an elderly population. Effect on hemoglobin and several serum nutritional indicators. J Am Geriatr Soc. 1986; 34(11):800-6. DOI: 10.1111/j.1532-5415.1986.tb03985.x. View

11.

Litchford M, Wakefield L . Nutrient intakes and energy expenditures of residents with senile dementia of the Alzheimer's type. J Am Diet Assoc. 1987; 87(2):211-3. View

12.

Kant A, Reynolds R . Effect of age on changes in plasma, erythrocyte, and urinary B-6 vitamers after an oral vitamin B-6 load. Am J Clin Nutr. 1988; 48(5):1284-90. DOI: 10.1093/ajcn/48.5.1284. View

13.

Fu C, SWENDSEID M, Jacob R, McKEE R . Biochemical markers for assessment of niacin status in young men: levels of erythrocyte niacin coenzymes and plasma tryptophan. J Nutr. 1989; 119(12):1949-55. DOI: 10.1093/jn/119.12.1949. View

14.

Bell I, Edman J, Miller J, Hebben N, Linn R, Ray D . Relationship of normal serum vitamin B12 and folate levels to cognitive test performance in subtypes of geriatric major depression. J Geriatr Psychiatry Neurol. 1990; 3(2):98-105. DOI: 10.1177/089198879000300208. View

15.

Pounder R, Hamilton M, Ball S, Chronos N, Raymond F, Olausson M . Twenty-four-hour intragastric acidity and plasma gastrin concentration before and during treatment with either ranitidine or omeprazole. Aliment Pharmacol Ther. 1987; 1(3):239-51. DOI: 10.1111/j.1365-2036.1987.tb00623.x. View

16.

Yao Y, Yao S, Yao S, Yao G, Lou W . Prevalence of vitamin B12 deficiency among geriatric outpatients. J Fam Pract. 1992; 35(5):524-8. View

17.

Pennypacker L, Allen R, Kelly J, MATTHEWS L, Grigsby J, Kaye K . High prevalence of cobalamin deficiency in elderly outpatients. J Am Geriatr Soc. 1992; 40(12):1197-204. View

18.

Joosten E, van den Berg A, Riezler R, Naurath H, Lindenbaum J, Stabler S . Metabolic evidence that deficiencies of vitamin B-12 (cobalamin), folate, and vitamin B-6 occur commonly in elderly people. Am J Clin Nutr. 1993; 58(4):468-76. DOI: 10.1093/ajcn/58.4.468. View

19.

Jacobson E . Niacin deficiency and cancer in women. J Am Coll Nutr. 1993; 12(4):412-6. DOI: 10.1080/07315724.1993.10718330. View

20.

Keller H . Malnutrition in institutionalized elderly: how and why?. J Am Geriatr Soc. 1993; 41(11):1212-8. DOI: 10.1111/j.1532-5415.1993.tb07305.x. View