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

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.