Improvement of cognitive functions after cobalamin/folate supplementation in elderly patients with dementia and elevated plasma homocysteine

Objectives To investigate the effect of cobalamin/folate supplementation on cognitive function in elderly patients with dementia. Method The cobalamin/folate status of the patients was evaluated by measuring plasma homocysteine, serum methylmalonic acid, serum cobalamin and blood folate. Thirty-three patients were studied and repeatedly assessed with the Mini-Mental State Examination (MMSE) and 'A short cognitive performance test for assessing memory and attention' (SKT) during vitamin substitution. Results Patients with mild-moderate dementia and elevated plasma homocysteine levels improved clinically with increased test scores after vitamin substitution, while severely demented patients and patients with normal plasma homocysteine levels did not improve clinically. Conclusions Plasma homocysteine may be the best marker for detecting treatable cobalamin/folate deficiency in patients with dementia. Copyright (C) 2001 John Wiley & Sons, Ltd.