1. RESEARCH POSTER PRESENTATION DESIGN © 2015
www.PosterPresentations.com
Vitamin B12 (Cobalamin) and folate are
interconnected cofactors/coenzymes which
participate in the normal functioning of the
“folate” and “methionine” cycles within the
body. The “folate” cycle is needed for DNA and
RNA synthesis as well as for the metabolism of
homocysteine to methionine. This methionine is
utilized in the “methionine” cycle which is
needed for methylation of DNA, RNA, proteins
and lipids. According to Kennedy increased
homocysteine levels have been linked to
decreased cognitive function, Alzheimer’s
disease (AD) and dementia.1
Understanding the role vitamin B12, folate and
total homocysteine (tHcy) levels in the body have
on cognition during different stages in life and
the effects supplementing these B vitamins can
produce can help with prevention of mental
deterioration and with mental development.
Introduction
Effects on Early Development & Long-Term Cognitive
Abilities
Associations between Alzheimer's
Disease and Blood Homocysteine,
Vitamin B12, and Folate: A Case-Control
Study
Chen H, Liu S, Ji L, et al. Associations between Alzheimer’s Disease and
Blood Homocysteine, Vitamin B12, and Folate: A Case-Control Study.
Current Alzheimer Research. 2015; 12:88-94.
Effects on Impaired Cognitive Function
Objective
 Investigate the correlation between
Alzheimer’s Disease (AD) and tHcy, vitamin
B12 and folate levels in the blood.
 Pressure to control the
increasing burden of AD
Methods
 Case–control study
 115 case subjects with AD were matched 1:1
(for age ± 3 yrs. & sex) with 115 control
subjects
 Serum folate and vitamin B12 were collected
and measured via automated immunoassay
analyzer
 Plasma tHcy was measured using high-
performance liquid chromatography
 Self-reported questionnaire, BMI, & use of
folic acid and vitamin B12 supplements
 Cognitive function was evaluated using a
version of MMSE (dementia-screening
instrument) and 20 ADL questions were
asked
Findings
 No significant differences (P≥0.05) between
education, handedness, living with others,
B12 supplement use, or folate supplement
use
 Significant differences (P≤0.05) between
marital status, BMI, smoking, alcohol use,
comorbid diseases, family history, MMSE
score and ADL score
 AD cases possessed higher tHcy levels
(P=0.000) , lower serum vitamin B12 levels
(P=0.000) and lower serum folate levels
(P=0.000)
Association between intake of B vitamins
and cognitive function in elderly Koreans
with cognitive impairment
Kim H, Kim G, Jang W, Kim SY, Chang N. Association between intake of B
vitamins and cognition function in elderly Koreans with cognitive
impairment. Nutrition Journal. 2014; 13:118.
Effects of Vitamin B12 Supplementation
Effects of vitamin B-12 supplementation and neurologic and cognitive function in
older people: a randomized controlled trial
Dangour AA, Allen E, Clarke R, et al. Effects of vitamin B-12 supplementation on neurological and cognitive function in older people: a randomized
controlled trial. Am J Clin Nur. 2015; 102:639-47.
Objective
 Conclude if daily supplementation of 1 mg of vitamin B12 for a duration of 12 months impacts
cognitive and neurological function in elderly people who possess a moderate B12 deficiency
 Little research on subjects who already possess a deficiency
Methods
 Double-blind, randomized, placebo-controlled clinical trial
 191 subjects aged ≥75 y with moderate vitamin B12 deficiency (serum vitamin B12 concentrations:
107-210 pmol/L) with absence of anemia
 99 of the subjects were treated with 1 mg of vitamin B12 daily, 120
subjects were give a placebo
 Data on diet, alcohol consumption, psychological health, education, medical history, current
prescribed medication , weight, height, and mobility were recorded at baseline & after 12 mo.
 Neurologic function was assessed at baseline and after 12 mo.
 Cognitive function was assessed at baseline and after 12 mo.
 At baseline and after 12 mo. blood was sampled from subjects and serum concentrations of
vitamin B12, holotranscobalamin, tHcy and folate were measured
Findings
 Vitamin B12 serum levels increased 177% after 12 mo. in treated subjects
 Holotranscobalamin serum levels increased 331% after 12 mo. in treated subjects
 Serum tHcy levels decreased 17% after 12 mo. in treated subjects
 No significant difference in neurological function with the allocated treatment at 12 mo.
 No significant difference in cognitive function or other secondary outcomes with the allocated
treatment at 12 mo.
Conclusion
 Vitamin B12, folate and homocysteine levels may have been shown to have lasting effects on brain
development and cognitive function if issues arise at the neonatal life stages.
 People with cognitive impairment such as AD and/or MCI may have lower serum levels of B12 and
folate, increased levels of tHcy and have decreased numbers of dietary and supplemental intake
 Supplementing B12 in those with mild B12 deficiencies may not improve cognitive/neurological
function.
 More research on specific stages during pregnancy, serum levels and dietary trends over
development of cognitive impairment, and supplementation of various combinations of B vitamins
is needed in the future. B vitamins are strongly interrelated in their cellular processes and research
on a wider range of B vitamins is needed.
Prenatal folate, homocysteine and vitamin B12 levels and child brain volumes,
cognitive development and psychological functioning: the Generation R Study
Ars CL, Nijs IM, Marroun HE, et al. Prenatal folate, homocysteine and vitamin B12 levels and child brain volumes, cognitive development and
psychological functioning: the Generation R Study. Br J Nutr. 2016; 1:1-9.
Human Nutrition and Chronic Disease, North Carolina State University
Kelsey M. Hall
Vitamin B-12 and Folate as Related to Cognitive Function
Objective
 Discover if a link between folate insufficiency, high total homocysteine levels and low vitamin
B12 levels in pregnant women were associated with abnormal brain morphology &
cognitive/psychological function in their offspring
Methods
 Nested case-control study within the Generation R Study
 62 Dutch children, 6-8 yrs., whose mothers had insufficient (<8 nmol/l) plasma folate during
early pregnancy and 194 similar controls with normal (<8 nmol/l) maternal plasma folate levels
 Maternal folate and tHcy concentrations analysis
 Evaluation of emotional and behavior issues
 IQ, neurocognitive abilities, and structural MRI data was collected
Findings
 An over-all decreased brain volume was found in the cases with low maternal plasma folate
 (P≤0.017)
 Emotional and behavioral problems were not significantly correlated
 IQ was significantly lower (7 points) in the cases with maternal tHcy concentrations of >9.1
µmol/l
 Cases with lower maternal plasma folate levels scored lower on neurocognitive abilities
Objective
 Examine the relationship between B vitamin
intake (dietary and supplementation) and
cognitive function
 With cognitive impairment
 South Korea = most rapidly aging pop.
Methods
 Case-control study
 100 cases with mild cognitive impairment
(MCI), 100 case with AD, and 121 controls
 All subjects older than 60
 Subjects completed the Korean version of the
Consortium to Establish a Registry for AD
(CERAD-K) assessment packet
 Dietary assessment through 24 hour recall of
all food and supplements consumed was
collected and analyses
 Plasma folate, vitamin B12 and tHcy
concentrations were analyzed
Findings
 Dietary and total B vitamins intake was
negatively associated with tHcy levels and
positively with cognitive function
 A connection between B vitamins intake and
cognitive function was stronger in AD cases
and MCI cases than in the controls
 AD cases also showed a
stronger connection than MCI
Maternal pregnancy tHcy level and IQ in Offspring
Figure 2. Shows a significant correlation (P≤0.05) between high tHcy concentration (>9.1 µmol/l)
and lower IQ . B, b value. 95% confidence interval.
tHcy (n 240) B 95% CI P
Model 1 -8.02 -12.11, -3.93 0.000*
Model 2 -7.05 -11.04, -3.06 0.001*
Model 3 -6.91 -10.92, -2.90 0.001*
Odds ratios for the association between AD and combined blood tHcy, vitamin B12 and folate levels
Group Crude OR
(95% CI)
Crude OR
P
Adjusted OR
(95% CI)
Adjusted OR
P
1 1.0 1.0
2 2.0(0.8-4.8) 0.120 2.2(0.9-5.5) 0.082
3 4.6(1.7-12.9) 0.003 4.6(1.6-13.2) 0.004
4 4.4(1.4-14.2) 0.013 4.3(1.3-14.6) 0.019
5 5.8(1.8-19.0) 0.004 6.4(1.9-21.6) 0.003
6 14.1(4.8-41.5) 0.000 17.0(5.4-53.4) 0.000
7 27.8(9.2-83.8) 0.000 30.5(9.7-95.9) 0.000
Figure 3. Various combinations of low and high values of tHcy, folate and
vitamin B12 were combined into different groups and analyzed. Results
indicated that high tHcy combined with low vitamin B12 were related to
AD development.
Correlation coefficients between B vitamins intake and plasma tHcy levels among
AD cases, MCI cases and the control
Total AD tHcy
(µmol/L)
MCI tHcy
(µmol/L)
Control tHcy
(µmol/L)
Vitamin
B2(mg/d) Diet
only
-0.172** 0.069 -0.204 0.053
Vitamin B2
(mg/d) Total
-0.185*** -0.182 -0.208* -0.133
Vitamin B6
(mg/d) Diet
only
-0.168** 0.075 0.098 0.015
Vitamin
B6(mg/d) Total
-0.183** -0.216* -0.130 -0.141
Vitamin
B12(µg/d) Diet
only
-0.115* -0.111 -0.053 -0.019
Vitamin
B12(µg/d)
Total
-0.127* -0.173 0.069 -0.143
Folate (µg
DFE/d) Diet
only
-0.036 -0.093 0.102 -0.031
Folate (µg
DFE/d) Total
-0.151** -0.121 -0.104 -0.063
(*p<0.05, **p<0.01, ***p<0.001)
Figure 4. Plasma tHcy was
negatively correlated with
total intake of vitamin B2,
(p<0.001), vitamin B6
(p<0.01), vitamin B12
(p<0.05) and folate (p<0.01).
Figure 1. Folate & Methionine Cycles 1
CVLT: California Verbal Learning Test
Treated (n=91)
Mean ± SE
Placebo (n=93)
Mean ± SE
Unadjusted effect size
Mean difference (95% CI)
Adjusted effect size
Mean difference (95% CI)
*adjusted for age and sex*
CVLT: Total words correct
in 3 trials, n
23.9 ± 0.7 24.6 ± 0.7 -1.4 (-2.9, 0.1) -1.4 (-2.9, 0.1)
CVLT: Words recalled at
delayed recall, n
7.5 ± 0.3 7.7 ± 0.4 -0.4 (-1.0, 0.2) -0.4 (-1.0, 0.2)
Symbol letter modality, n
correct
39.6 ± 1.1 40.1 ± 1.2 -1.3 (-3.2, 0.6) -1.3 (-3.2, 0.6)
Reaction time, s
Simple
0.3 ± 0.01 0.3 ± 0.01 0.01 (-0.02, 0.04) 0.01 (-0.02, 0.04)
Reaction time, s
Choice
0.7 ± 0.01 0.7 ± 0.02 -0.003 (-0.03, 0.02) -0.003 (-0.03, 0.02)
Verbal fluency, n animals
named
20.8 ± 0.5 19.9 ± 0.6 1.1 (-0.1, 2.2) 1.1 (-0.1, 2.2)
30-item General Health
Question score
*n=5 in treated & n=11 in
placebo*
2.4 ± 0.5 2.7 ± 0.5 -0.1 (-1.2, 1.0) -0.1 (-1.3, 1.1)
Effects of vitamin B12 on cognitive and psychological function outcomes at 12 mo.
Figure 5. Difference between treated and placebo after 12 mo. were minimal as indicated by mean
differences. Results of the trial did not support the hypothesis.
1. Kennedy D. B Vitamins and the Brain: Mechanisms, Dose and Efficacy – A
Review. Nutrients. 2016; 8: 1-69.