Low blood folate may be linked to heightened dementia and death risks in older people

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Research published online in The Journal suggests that low levels folate (vitamin B9) in blood could be linked to an increased risk of dementia in older people. Evidence-based Mental Health.

The researchers recommend that folate levels be checked regularly and that deficiencies are corrected in older people.

Evidence to date suggests that folate deficiencies can affect cognition and nerve signaling in brains, making them a risk factor for dementia later on.

However, the few studies that have examined this issue have had limited numbers of participants and produced mixed results.

Because of the length of time it takes for dementia develop, it’s difficult to rule out reverse causality. Folate deficiency could be a result of pre-clinical rather than a cause of it, they add.

They wanted to determine if serum folate deficiencies might be associated with the risk of incident dementia and death due to any cause in a large population of older adults.

They used the medical records of 27,188 Israelis who were served by one national health provider. All participants were between 60-75 years old and had not had any pre-existing dementia since at least 10 years prior to blood folate checks started in 2013.

The records of the deceased were monitored until 2017 for signs of dementia and death.

Just under 13 percent of the participants were folate deficient. Folate deficiency is defined as a level below 4.4 ng/ml. Folate deficiency was associated to a significantly higher risk of dementia and death from any cause.

Folate deficient individuals had a higher incidence of dementia than those with normal levels. Death from any cause was 19.20 per 10,000 years.

This compares to an estimated dementia incidence rate of 4.24, and death from any cause of death of 5.36 per 10,000 years for those who were not folate deficient.

In percentage terms, dementia rates were close to 3.5% and death from any cause was just under 8.8% for folate deficient people. This compares to dementia rates of just above 3% and death from any cause of nearly 4% for those who were not folate deficient.

After taking into account other factors such as co-existing diabetes, depression and cognitive decline, vitamin D deficiency, smoking, and folic acid supplement use, folate deficient people were 68% more likely than others to develop dementia. They also had a 3x higher chance of dying from any cause.

Additional analyses didn’t significantly weaken observed associations but, when stratified according to length of monitoring period it was impossible to rule out reverse causation.

This is an observational study and cannot prove cause.

It is possible that folate deficiency may affect homocysteine levels and thus the vascular risk for dementia. They also explain that DNA repair of neurons might be compromised by folate, making them susceptible to oxidative damage. This could increase brain cell damage and speed up brain cell aging.

They conclude that “Serum folate concentrations could function as a biomarker for modifying the risks of death and dementia in old age,” and that older adults should be routinely tested for folate deficiency.

“The implications for public policy seem to be to reliably monitor serum folate concentrations in older adults, treat deficiency for preventative actions and/or as part a implemented therapeutic strategy while regularly reviewing patients’ clinical outcomes,” they write.

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More information:
Low blood folate could be linked to increased dementia and death rates in older adults Evidence-based Mental Health, 2022. DOI: 10.1136/ebmental-2021-300309

Provided by
British Medical Journal

Low blood folate levels may increase dementia and death risk in older people (2022, 15 March)
Retrieved 16 March 2022

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Source: medical xpress.

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