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September 26, 2011

Vitamin B12, cognition, and brain MRI measures
A cross-sectional examination

This article has been corrected.
VIEW CORRECTION
September 27, 2011 issue
77 (13) 1276-1282

Abstract

Objective:

To investigate the interrelations of serum vitamin B12 markers with brain volumes, cerebral infarcts, and performance in different cognitive domains in a biracial population sample cross-sectionally.

Methods:

In 121 community-dwelling participants of the Chicago Health and Aging Project, serum markers of vitamin B12 status were related to summary measures of neuropsychological tests of 5 cognitive domains and brain MRI measures obtained on average 4.6 years later among 121 older adults.

Results:

Concentrations of all vitamin B12–related markers, but not serum vitamin B12 itself, were associated with global cognitive function and with total brain volume. Methylmalonate levels were associated with poorer episodic memory and perceptual speed, and cystathionine and 2-methylcitrate with poorer episodic and semantic memory. Homocysteine concentrations were associated with decreased total brain volume. The homocysteine-global cognition effect was modified and no longer statistically significant with adjustment for white matter volume or cerebral infarcts. The methylmalonate-global cognition effect was modified and no longer significant with adjustment for total brain volume.

Conclusions:

Methylmalonate, a specific marker of B12 deficiency, may affect cognition by reducing total brain volume whereas the effect of homocysteine (nonspecific to vitamin B12 deficiency) on cognitive performance may be mediated through increased white matter hyperintensity and cerebral infarcts. Vitamin B12 status may affect the brain through multiple mechanisms.

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Information & Authors

Information

Published In

Neurology®
Volume 77Number 13September 27, 2011
Pages: 1276-1282
PubMed: 21947532

Publication History

Received: January 25, 2011
Accepted: June 7, 2011
Published online: September 26, 2011
Published in print: September 27, 2011

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Disclosure

Dr. Tangney receives research support from the NIH/NIA. Dr. Aggarwal has served on a scientific advisory board for Pfizer Inc and receives research support from the NIH and the Alzheimer's Association. H. Li reports no disclosures. Dr. Wilson serves on editorial advisory boards for Aging, Neuropsychology, and Cognition and Psychology and Aging; serves as a consultant for Pain Therapeutics, Inc.; and receives research support from the NIH/NIA. Dr. DeCarli serves as Editor-in-Chief for Alzheimer Disease and Associated Disorders; serves as a consultant for Bayer Schering Pharma and Avanir Pharmaceuticals; and receives research support from the NIH (NIA, NHLBI). Dr. Evans has served on a data monitoring committee for Eli Lily and Company; and receives research support from the NIH. Dr. Morris has received research support from the US Department of Health and Human Services, the NIH/NIA, the Abbott Fund, and the Sprague Institute.

Authors

Affiliations & Disclosures

C.C. Tangney, PhD
From the Department of Clinical Nutrition (C.C.T.), Section of Nutrition & Nutritional Epidemiology, Department of Internal Medicine (C.C.T., H.L., M.C.M.), Rush Institute for Healthy Aging, Chicago; Departments of Internal Medicine (N.T.A., R.S.W., D.A.E.), Preventive Medicine (D.A.E., M.C.M.), and Neurological Sciences (N.T.A., R.S.W.), Rush Alzheimer's Disease Center (N.T.A., R.S.W., D.A.E.), Rush University Medical Center, Chicago, IL; and Department of Neurology and Center for Neuroscience (C.D.), University of California-Davis, Sacramento, CA.
N.T. Aggarwal, MD
From the Department of Clinical Nutrition (C.C.T.), Section of Nutrition & Nutritional Epidemiology, Department of Internal Medicine (C.C.T., H.L., M.C.M.), Rush Institute for Healthy Aging, Chicago; Departments of Internal Medicine (N.T.A., R.S.W., D.A.E.), Preventive Medicine (D.A.E., M.C.M.), and Neurological Sciences (N.T.A., R.S.W.), Rush Alzheimer's Disease Center (N.T.A., R.S.W., D.A.E.), Rush University Medical Center, Chicago, IL; and Department of Neurology and Center for Neuroscience (C.D.), University of California-Davis, Sacramento, CA.
H. Li, MS
From the Department of Clinical Nutrition (C.C.T.), Section of Nutrition & Nutritional Epidemiology, Department of Internal Medicine (C.C.T., H.L., M.C.M.), Rush Institute for Healthy Aging, Chicago; Departments of Internal Medicine (N.T.A., R.S.W., D.A.E.), Preventive Medicine (D.A.E., M.C.M.), and Neurological Sciences (N.T.A., R.S.W.), Rush Alzheimer's Disease Center (N.T.A., R.S.W., D.A.E.), Rush University Medical Center, Chicago, IL; and Department of Neurology and Center for Neuroscience (C.D.), University of California-Davis, Sacramento, CA.
R.S. Wilson, PhD
From the Department of Clinical Nutrition (C.C.T.), Section of Nutrition & Nutritional Epidemiology, Department of Internal Medicine (C.C.T., H.L., M.C.M.), Rush Institute for Healthy Aging, Chicago; Departments of Internal Medicine (N.T.A., R.S.W., D.A.E.), Preventive Medicine (D.A.E., M.C.M.), and Neurological Sciences (N.T.A., R.S.W.), Rush Alzheimer's Disease Center (N.T.A., R.S.W., D.A.E.), Rush University Medical Center, Chicago, IL; and Department of Neurology and Center for Neuroscience (C.D.), University of California-Davis, Sacramento, CA.
C. DeCarli, MD
From the Department of Clinical Nutrition (C.C.T.), Section of Nutrition & Nutritional Epidemiology, Department of Internal Medicine (C.C.T., H.L., M.C.M.), Rush Institute for Healthy Aging, Chicago; Departments of Internal Medicine (N.T.A., R.S.W., D.A.E.), Preventive Medicine (D.A.E., M.C.M.), and Neurological Sciences (N.T.A., R.S.W.), Rush Alzheimer's Disease Center (N.T.A., R.S.W., D.A.E.), Rush University Medical Center, Chicago, IL; and Department of Neurology and Center for Neuroscience (C.D.), University of California-Davis, Sacramento, CA.
D.A. Evans, MD
From the Department of Clinical Nutrition (C.C.T.), Section of Nutrition & Nutritional Epidemiology, Department of Internal Medicine (C.C.T., H.L., M.C.M.), Rush Institute for Healthy Aging, Chicago; Departments of Internal Medicine (N.T.A., R.S.W., D.A.E.), Preventive Medicine (D.A.E., M.C.M.), and Neurological Sciences (N.T.A., R.S.W.), Rush Alzheimer's Disease Center (N.T.A., R.S.W., D.A.E.), Rush University Medical Center, Chicago, IL; and Department of Neurology and Center for Neuroscience (C.D.), University of California-Davis, Sacramento, CA.
M.C. Morris, ScD
From the Department of Clinical Nutrition (C.C.T.), Section of Nutrition & Nutritional Epidemiology, Department of Internal Medicine (C.C.T., H.L., M.C.M.), Rush Institute for Healthy Aging, Chicago; Departments of Internal Medicine (N.T.A., R.S.W., D.A.E.), Preventive Medicine (D.A.E., M.C.M.), and Neurological Sciences (N.T.A., R.S.W.), Rush Alzheimer's Disease Center (N.T.A., R.S.W., D.A.E.), Rush University Medical Center, Chicago, IL; and Department of Neurology and Center for Neuroscience (C.D.), University of California-Davis, Sacramento, CA.

Notes

Study funding: Supported by the NIH/NIA (AG11101 and AG13170).
Address correspondence and reprint requests to Dr. Christine C. Tangney, Department of Clinical Nutrition 425 TOB, Rush University Medical Center, 1700 West Van Buren St., Chicago, IL 60612 [email protected]

Author Contributions

Dr. Tangney: draft/revise manuscript, study concept or design, analysis or interpretation of data, acquisition of data, statistical analysis. Dr. Aggarwal: draft/revise manuscript, study concept or design, analysis or interpretation of data, contribution of patients/tools, acquisition of data, study coordination. H. Li: analysis or interpretation of data, acquisition of data, statistical analysis. Dr. Wilson: draft/revise manuscript, contribution of patients/tools. Dr. DeCarli: draft/revise manuscript, analysis or interpretation of data, contribution of patients/tools, acquisition of data. Dr. Evans: draft/revise manuscript, analysis or interpretation of data, contribution of patients/tools, acquisition of data, obtaining funding. Dr. Morris: draft/revise manuscript, study concept or design, analysis or interpretation of data, contribution of patients/tools, acquisition of data, statistical analysis, obtaining funding.

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