Dementia and vitamin B12 deficiency: review of the literature and presentation of one case

Тhere are some very important facts about B-12 levels in the normal population, especially the elderly. There is evidence that low B-12 levels occur in 10 % of older people, and the prevalence increases with age from five percent at age 65 to
20 percent at age 85. General Practitioners (GPs) in the UK are advised to offer patients a blood test for vitamin B12 deficiency if they see one symptom and one risk factor, in new guidance currently under consultation (NICE).
Some studies have shown a correlation between B-12 levels and cognitive decline. Other studies, on the contrary, have questioned the correlation between dementia and serum cobalamin levels and the reversibility of dementia under
cobalamin substitution. There is also study that B12 is a cholinergic modulator compensating for cholinergic neurons loss in Alzheimer’s disease (AD). Some authors found improvement of cognitive dysfunction in patients with low
serum cobalamin only if symptoms persisted for less than 1 year. Chronic dementia seems to respond poorly but should, nevertheless, be treated if there is metabolic evidence for vitamin B12 deficiency. Vitamin B12 assay slowly becomes a part of the routine investigation of dementia in our country. Through the brief conclusions of several relevant papers, we want to discuss some issues of the given topic. We also present a case report of a patient with dementia
and B12 deficiency, with a chronological follow-up of the clinical course and cognitive tests such as MMSE, Addenbrooke’s Cognitive Examination III (ACE III) and The clock-drawing test.
Keywords: Vitamin B12 Deficiency - Alzheimer’s disease - cognitive decline