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 measuri ng plasma homocysteine, serum methylmalonic acid, serum cobalamin and blood folate. Thirty-three patients were studied and repeatedly assessed with th e Mini-Mental State Examination (MMSE) and 'A short cognitive performance t est for assessing memory and attention' (SKT) during vitamin substitution. Results Patients with mild-moderate dementia and elevated plasma homocystei ne levels improved clinically with increased test scores after vitamin subs titution, 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 treata ble cobalamin/folate deficiency in patients with dementia. Copyright (C) 20 01 John Wiley & Sons, Ltd.