Interactions between plasma concentrations of folate and markers of vitamin B12status with cognitive performance in elderly people not exposed to folic acid fortification: the Hordaland Health Study

Doets, Esmée L.; Ueland, Per M.; Tell, Grethe S.; Vollset, Stein Emil; Nygård, Ottar K.; van't Veer, Pieter; de Groot, Lisette C. P. G. M.; Nurk, Eha; Refsum, Helga; Smith, A. David; Eussen, Simone J. P. M.

doi:10.1017/s000711451300336x

Cited by 50Folate and B Vitamins ResearchDementia and Cognitive Impairment ResearchNutritional Studies and Diet

Interactions between plasma concentrations of folate and markers of vitamin B12status with cognitive performance in elderly people not exposed to folic acid fortification: the Hordaland Health Study

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Doets, Esmée L., Ueland, Per M., Tell, Grethe S., Vollset, Stein Emil, Nygård, Ottar K., van't Veer, Pieter, de Groot, Lisette C. P. G. M., Nurk, Eha +3 more·2014·British Journal Of Nutrition

DOI 10.1017/s000711451300336x

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Abstract

A combination of high folate with low vitamin B12 plasma status has been associated with cognitive impairment in a population exposed to mandatory folic acid fortification. The objective of the present study was to examine the interactions between plasma concentrations of folate and vitamin B12 markers in relation to cognitive performance in Norwegian elderly who were unexposed to mandatory or voluntary folic acid fortification. Cognitive performance was assessed by six cognitive tests in 2203 individuals aged 72-74 years. A combined score was calculated using principal component analysis. The associations of folate concentrations, vitamin B12 markers (total vitamin B12, holotranscobalamin (holoTC) and methylmalonic acid (MMA)) and their interactions in relation to cognitive performance were evaluated by quantile regression and least-squares regression, adjusted for sex, education, apo-ɛ4 genotype, history of CVD/hypertension and creatinine. Cross-sectional analyses revealed an interaction (P= 0·009) between plasma concentrations of folate and vitamin B12 in relation to cognitive performance. Plasma vitamin B12 concentrations in the lowest quartile ( < 274 pmol/l) combined with plasma folate concentrations in the highest quartile (>18·5 nmol/l) were associated with a reduced risk of cognitive impairment compared with plasma concentrations in the middle quartiles of both vitamins (OR 0·22, 95 % CI 0·05, 0·92). The interaction between folate and holoTC or MMA in relation to cognitive performance was not significant. In conclusion, this large study population unexposed to mandatory folic acid fortification showed that plasma folate, but not plasma vitamin B12, was associated with cognitive performance. Among the elderly participants with vitamin B12 concentrations in the lower range, the association between plasma folate and cognitive performance was strongest.

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Low folate status is associated with higher risk of cognitive decline or dementia.
“Additional evidence comes from longitudinal studies, such as in a prospective cohort that enrolled more than 7000 women aged 65–79 years: low baseline folate intakes (i.e., below the recommended 400 µg/day) or low serum folate concentrations were significantly associated with a higher risk of cognitive decline or dementia during a 5 year follow-up [163].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [160]

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Additional file 2 of Dynamics and interactions of cobalamin and folate status during advanced aging – a longitudinal study in a community-dwelling cohort with multiple follow-ups
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Additional file 1 of Dynamics and interactions of cobalamin and folate status during advanced aging – a longitudinal study in a community-dwelling cohort with multiple follow-ups
Jungert, A., Zenke‐Philippi, C., & Neuhäuser‐Berthold, M. (2020) · Figshare · doi:10.6084/m9.figshare.12606913

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Authors: Doets, E. L., Ueland, P. M., Tell, G. S., Vollset, S. E., Nygård, O. K., van't Veer, P., de Groot, L. C. P. G. M., Nurk, E., Refsum, H., Smith, A. D., & Eussen, S. J. P. M.
Affiliations: Wageningen University & Research (NL)
Haukeland University Hospital (NO)
University of Bergen (NO)
University of Oslo (NO)
University of Oxford (GB)
Corresponding author: Doets, Esmée L.
ORCID: Doets, Esmée L.
Ueland, Per M.
Tell, Grethe S.
Nurk, Eha
Refsum, Helga
Smith, A. David
Eussen, Simone J. P. M.
Venue: British Journal Of Nutrition
Publisher: Cambridge University Press (CUP)
Published: 2013-11-11
Volume: 111
Issue: 6
Pages: 1085-1095
ISSN: 0007-1145 (ISSN-L)
1475-2662
DOI: 10.1017/s000711451300336x
OpenAlex: W2134824125
Cited by: 50
References: 66
Citations by year: 2025: 5 · 2024: 2 · 2023: 6 · 2022: 3 · 2021: 4 · 2020: 13 · 2019: 5 · 2018: 2 · 2017: 6 · 2016: 3 · 2014: 1
FWCI: 1.09
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified)
Locations: British Journal Of Nutrition (publishedVersion)
PubMed (publishedVersion)
Research Publications (Maastricht University) (publishedVersion, other-oa)
Socio-Environmental Systems Modeling (acceptedVersion)
Research Publications (Maastricht University) (submittedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: Norman Collisson Foundation
Topics: Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords: plasma folate, vitamin B12 status, cognitive performance, cognitive impairment, older adults, folic acid fortification, vitamin B12 deficiency, methylmalonic acid, holotranscobalamin, Hordaland Health Study
MeSH terms: Aged, Cognition Disorders, Cross-Sectional Studies, Diet, Female, Folic Acid, Food, Fortified, Homocysteine, Humans, Male, Methylmalonic Acid, Norway, Nutritional Status, Transcobalamins, Vitamin B 12, Vitamin B 12 Deficiency, Biomarkers

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Interactions between plasma concentrations of folate and markers of vitamin B12status with cognitive performance in elderly people not exposed to folic acid fortification: the Hordaland Health Study

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