Association of vitamin B12 deficiency in a dementia cohort with hippocampal atrophy on MRI.

Abstract

Background: Vitamin deficiencies have been reported to cause brain atrophy. Hippocampal atrophy has been well reported in patients with dementia including Alzheimer's disease.

Objectives: To investigate the association between hippocampal atrophy and vitamin deficiency DESIGN: Cross sectional study SETTING: Three sites in one country PARTICIPANTS: Overall, 567 patients who visited an outpatient dementia clinic and underwent MRI-VSRAD (Voxel-Based Specific RegionalAnalysis System for Alzheimer's Disease) were included in this study.

Intervention: Patients with a hippocampal atrophy Z-score of < 2 were classified as normal (n = 323), and those with a Z-score of ≥ 2 were diagnosed with hippocampal atrophy (n = 244).

Measurements: Vitamin B₁₂, folic acid, vitamin B₁, homocysteine, HbA1c, and creatinine levels were measured and their association with hippocampal atrophy was assessed. Age, MMSE (Mini Mental State Examination), and hippocampal atrophy were also evaluated.

Results: In the hippocampal atrophy group, the frequency of vitamin B₁₂ deficiency was higher (p < 0.022), MMSE score was lower (p < 0.0001), and age was higher (p < 0.0001) than that in the normal group (Mann-Whitney U test). Patients with vitamin B₁₂ deficiency (odds ratio, 3.46) and low MMSE score (odds ratio, 2.24) had an increased risk of hippocampal atrophy.

Conclusion: Vitamin B₁₂ deficiency was associated with hippocampal atrophy detected by VSRAD analysis. Therefore, early vitamin B₁₂ supplementation should be considered in patients with deficiencies to reduce dementia risk.