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Gender differences in folate status are associated with cognition in healthy Irish elderly adults

Published online by Cambridge University Press:  15 August 2011

E. M. O'Connor ,
G. F. Fitzgerald  and
P. W. O'Toole
E. M. O'Connor
Affiliation:
Department of Microbiology, University College, Cork, Ireland
G. F. Fitzgerald
Affiliation:
Department of Microbiology, University College, Cork, Ireland Alimentary Pharmabiotic Centre, University College, Cork, Ireland
P. W. O'Toole
Affiliation:
Department of Microbiology, University College, Cork, Ireland Alimentary Pharmabiotic Centre, University College, Cork, Ireland
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Abstract

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Abstract
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Proceedings of the Nutrition Society , Volume 70 , Issue OCE3: Joint Irish Section and American Society for Nutrition Meeting, 15–17 June 2011, 70th anniversary: ‘Vitamins in early development and healthy ageing: impact on infectious and chronic disease’ , 2011 , E64
Copyright
Copyright © The Authors 2011

In elderly populations, cognitive impairment and incident dementia may be related to inadequate vitamin B status, predominantly folate and vitamin B12. Folate deficiency has been associated with Alzheimer's disease as well as preceding the onset of other dementia(Reference Tettamanti1), while low folate and vitamin B12 have been associated with depressive symptoms(Reference Robinson2). Functional deterioration may also increase with folate deficiency(Reference Johnson3). The aim of this study was to examine associations between B vitamins (serum folate and vitamin B12) and measures of cognition in a sample of healthy Irish adults.

Serum vitamin B12 and folate concentrations were measured by ELISA in 194 community-dwelling and day hospital patients (aged 64–95 years) who participated in the ELDERMET project. Cognitive and functional evaluation included the Mini Mental State Exam (MMSE) and Barthel Index of Activities of Daily Living, while the Geriatric Depression scale was used as a screening tool for depression.

Linear regression analysis showed that folate and vitamin B12 were positively associated (adj. R 2 for model=0.14, β=0.387, P=0.001). Male subjects had significantly lower mean folate (P=0.012) and vitamin B12 (P=0.014) status than females (see Table). After stratification by gender, linear regression analyses in females showed folate status to be positively associated with MMSE score (adj. R 2 for model=0.10, β=0.333, P=0.003) accounting for age and BMI. These associations were not evident in males. A trend for increased co-morbidity was also observed in male subjects compared to females (P for trend=0.055). Folate and vitamin B12 status were not associated with other measures of cognition, functionality and depression in males or females.

A one-way ANOVA showed a significant increase (improvement) in MMSE scores with increasing tertile of folate status in females (P=0.004). Subjects in the lowest tertile of folate had a significantly lower MMSE score (mean score=26.0) compared to those in the middle (mean score=27.9) and highest tertiles (mean score=28.4). These associations were not present in males (P>0.1).

In conclusion, folate status was better in females compared to males. Cognitive function, measured by MMSE score, increased with increasing folate status in females but not in males. Folate status in the elderly should be monitored as inadequacy could contribute to the brain ageing process and cognitive decline.

References

1.Tettamanti, et al. (2006) J Am Coll Nutr 25, 502–508.CrossRefGoogle Scholar
2.Robinson, et al. (2011) Int J Geriatr Psychiatry 26, 307–313.CrossRefGoogle Scholar
3.Johnson, et al. (1990) Vitamin Disorders in the Elderly. pp. 117–147. New York: Raven Press Ltd.Google Scholar