Serum folate, vitamin B-12 and cognitive function in middle and older age: The HAPIEE study

Pia Horvat; Julian Gardiner; Ruzena Kubinova; Andrzej Pajak; Abdonas Tamosiunas; Ben Schöttker; Hynek Pikhart; Anne Peasey; Eugene Jansen; Martin Bobak

doi:10.1016/j.exger.2016.01.011

Serum folate, vitamin B-12 and cognitive function in middle and older age: The HAPIEE study

Exp Gerontol. 2016 Apr:76:33-8. doi: 10.1016/j.exger.2016.01.011. Epub 2016 Jan 22.

Authors

Affiliations

¹ Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London WC1E 7HB, UK. Electronic address: [email protected].
² Department of Education, University of Oxford, 15 Norham Gardens, Oxford OX2 6PY, UK.
³ National Institute of Public Health, Srobarova 48, 10042 Prague, Czech Republic.
⁴ Department of Epidemiology and Population Studies, Jagellonian University Collegium Medicum, Grzegorzecka 20, 31-531 Krakow, Poland.
⁵ Department of Population Studies, Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas LT-50161, Lithuania.
⁶ Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Im Neuenheimer Feld 581, 69120 Heidelberg, Germany.
⁷ Department of Epidemiology & Public Health, UCL, 1-19 Torrington Place, London WC1E 7HB, UK.
⁸ Center for Health Protection, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, The Netherlands.

Abstract

Background: Nutrient status of B vitamins, particularly folate and vitamin B-12, may be related to cognitive ageing but epidemiological evidence remains inconclusive.

Objective: The aim of this study was to estimate the association of serum folate and vitamin B-12 concentrations with cognitive function in middle-aged and older adults from three Central and Eastern European populations.

Methods: Men and women aged 45-69 at baseline participating in the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) study were recruited in Krakow (Poland), Kaunas (Lithuania) and six urban centres in the Czech Republic. Tests of immediate and delayed recall, verbal fluency and letter search were administered at baseline and repeated in 2006-2008. Serum concentrations of biomarkers at baseline were measured in a sub-sample of participants. Associations of vitamin quartiles with baseline (n=4166) and follow-up (n=2739) cognitive domain-specific z-scores were estimated using multiple linear regression.

Results: After adjusting for confounders, folate was positively associated with letter search and vitamin B-12 with word recall in cross-sectional analyses. In prospective analyses, participants in the highest quartile of folate had higher verbal fluency (p<0.01) and immediate recall (p<0.05) scores compared to those in the bottom quartile. In addition, participants in the highest quartile of vitamin B-12 had significantly higher verbal fluency scores (β=0.12; 95% CI=0.02, 0.21).

Conclusions: Folate and vitamin B-12 were positively associated with performance in some but not all cognitive domains in older Central and Eastern Europeans. These findings do not lend unequivocal support to potential importance of folate and vitamin B-12 status for cognitive function in older age. Long-term longitudinal studies and randomised trials are required before drawing conclusions on the role of these vitamins in cognitive decline.

Keywords: Ageing; Biomarkers; Cognitive function; Eastern Europe; Folate; Vitamin B-12.

Publication types

Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Aged
Aging / blood*
Aging / psychology*
Biomarkers / blood
Cognition*
Cross-Sectional Studies
Europe
Female
Folic Acid / blood*
Geriatric Assessment
Humans
Linear Models
Male
Memory, Short-Term
Middle Aged
Neuropsychological Tests
Nutrition Assessment
Nutritional Status
Prospective Studies
Verbal Behavior
Vitamin B 12 / blood*

Substances

Biomarkers
Folic Acid
Vitamin B 12

Abstract

Publication types

MeSH terms

Substances

Grants and funding