A trial of B vitamins and cognitive function among women at high risk of cardiovascular disease
Open accessAbstract
Background High homocysteine concentrations may be neurotoxic and contribute to cognitive decline in older persons.Objective The objective was to examine the effect of supplementation with folic acid, vitamin B-12, and vitamin B-6 on cognitive change in women with cardiovascular disease (CVD) or CVD risk factors.Design The Women's Antioxidant and Folic Acid Cardiovascular Study is a randomized placebo-controlled trial designed to test the effect of a combination of B vitamins (2.5 mg folic acid/d, 50 mg vitamin B-6/d, and 1 mg vitamin B-12/d) on secondary prevention of CVD. Female health professionals aged >or=40 y (n = 5442) with CVD or >or=3 coronary risk factors in 1998 (after folic acid fortification began in the United States) were randomly assigned to treatment. Shortly after randomization (mean: 1.2 y), a substudy of cognitive function was initiated among 2009 participants aged >or=65 y. Telephone cognitive function testing was administered up to 4 times over 5.4 y with 5 tests of general cognition, verbal memory, and category fluency. Repeated-measures analyses were conducted, and the primary outcome was a global composite score averaging all test results.Results Mean cognitive change from baseline did not differ between the B vitamin and placebo groups (difference in change in global score: 0.03; 95% CI: -0.03, 0.08; P = 0.30). However, supplementation appeared to preserve cognition among women with a low baseline dietary intake of B vitamins.Conclusions Combined B vitamin supplementation did not delay cognitive decline among women with CVD or CVD risk factors. The possible cognitive benefits of supplementation among women with a low dietary intake of B vitamins warrant further study.
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There is some evidence that a Mediterranean diet can reduce cognitive decline.
“There is some evidence that a Mediterranean diet can reduce cognitive decline.301”
From Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (2011) · cites this paper as [301]
The Introduction and Discussion (page unavailable) address homocysteine lowering and B-vitamin supplementation, not a Mediterranean diet. Searches for “Mediterranean diet cognitive decline” and “Mediterranean dietary pattern cognitive function” found no passage in our copy addressing whether that diet reduces cognitive decline. (LLM, conf=0.78)
Experimental — accuracy not yet measuredIn a 13-year supplementation trial of B vitamins (B6 + B9 + B12) in women with high cardiovascular risk, no cognitive improvement was shown in the whole population of 5442 women.
“No cognitive improvement was shown in the whole population of 5 442 women, but a sub-analysis in those women who had a low baseline dietary intake of B vitamins (less than 1.9 mg/day for vitamin B6 and less than 279 µg/day for vitamin B9) showed that supplementation preserved cognitive capacities in this group at the 13 year assessment [222].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [222]
In a sub-analysis of that trial, women with low baseline dietary intake of B vitamins (less than 1.9 mg/day vitamin B6 and less than 279 μg/day vitamin B9) had preserved cognitive capacities at the 13-year assessment with supplementation.
“a sub-analysis in those women who had a low baseline dietary intake of B vitamins (less than 1.9 mg/day for vitamin B6 and less than 279 µg/day for vitamin B9) showed that supplementation preserved cognitive capacities in this group at the 13 year assessment [222].”
From Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence (2020) · cites this paper as [222]
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References 42 · Cited by 114
Research works printed but not linked: 1
- [13]Albert CM Cook NR Gaziano JM Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease JAMA 2008 299 2027 2036 18460663 PMC2684623
- Authors
- Kang, J. H., Cook, N., Manson, J., Buring, J. E., Albert, C. M., & Grodstein, F.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Kang, Jae Hee
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2008-12
- Volume
- 88
- Issue
- 6
- Pages
- 1602-1610
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC3470481
- OpenAlex
- W2013204019
- Cited by
- 114
- References
- 42
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 14 · 2020: 3 · 2019: 2 · 2018: 8 · 2017: 2 · 2016: 4 · 2015: 11 · 2014: 9 · 2013: 10 · 2012: 12
- FWCI
- 6.90
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1r43hl047959-01)
- National Institute on Aging (AG15933, R01AG015933)
- National Heart, Lung, and Blood Institute (HL47959, R01HL046959)
- 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 › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- vitamin B supplementation, folic acid, vitamin B12, vitamin B6, cognitive decline, cognitive function, cardiovascular disease, cardiovascular risk factors, older women, homocysteine, verbal memory, semantic fluency
- MeSH terms
- Aged, Aged, 80 and over, Cardiovascular Diseases, Cognition, Cognition Disorders, Double-Blind Method, Female, Folic Acid, Follow-Up Studies, Homocysteine, Humans, Psychometrics, Risk Factors, Vitamin B Complex, Vitamin B 12, Chi-Square Distribution, Statistics, Nonparametric, Dietary Supplements, Hyperhomocysteinemia, Vitamin B 6
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