Vitamin B12 deficiency is one of the most overlooked nutrient deficiencies that can affect several bodily systems, including the Central Nervous System (CNS). In fact, long term vitamin B12 deficiency can cause nerve damage and may lead to persistent neurological symptoms. Many times, these symptoms can mimic or be confused with dementia, which can lead to delay in early diagnosis and treatment.
Therefore, in an interaction with the OnlyMyHealth team, Dr Aparna R Pai, Professor, Unit Head, and Head of Department (HoD) of Neurology, Kasturba Medical College, MAHE, Manipal, discussed the overlapping nature of vitamin B12 deficiency and dementia and laid down the differences between the two.
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What Is Vitamin B12 Deficiency?
Vitamin B12, also known as cobalamin, is an essential nutrient that helps maintain healthy blood and nerve cells. It assists in the process of DNA formation, which is a genetic material in all the cells and also reduces the risk of megaloblastic anaemia, a condition that leads to the formation of unusually large, structurally abnormal blood cells. In addition, it is also responsible for the healthy functioning of the nervous system.
When it comes to vitamin B12, the problem is that our body cannot produce it and therefore, it has to depend on food sources and supplements. Low levels of B12 vitamin is often seen among vegetarians and vegans as this mineral is not found in plant-based food products.
A 2013 study published in the Journal Nutrition Reviews found that the deficiency rates were higher among vegans compared with vegetarians and among individuals who had followed a vegetarian diet since birth compared with those who had adopted such a diet later in life. The researchers also found that the prevalence of vitamin B12 deficiency was 62% among pregnant women, between 25% and almost 86% among children, 21-41% among adolescents, and 11-90% among the elderly.
What Is Dementia?
Dementia refers to the loss of cognitive functions, such as poor memory, lack of concentration, difficulty collecting thoughts, so much so that it starts affecting one's day to day life. It is important to note that dementia is not a disease in itself, rather a general term for several diseases, including Alzheimer's.
According to the World Health Organization (WHO), more than 5.5 crore people have dementia worldwide, with one crore new cases occurring every year. Alzheimer's disease is the most common form of dementia and may contribute to 60–70% of cases, the global health body shares.
Vitamin B12 Deficiency Versus Dementia: The Similarities
Dr Pai stressed on certain symptoms of dementia and vitamin B12 insufficiency that may be similar, which could cause misunderstanding in the diagnosis.
“It's crucial to remember that although these symptoms may coexist, they may also be signs of different medical disorders,” she said, adding, “Symptoms like cognitive impairment, sudden changes in mood, challenges with balancing and coordinating, feeling fatigue and weak, and difficulty in speech can be similar in both vitamin B12 deficiency and dementia, which is why it is always advisable to consult your healthcare provider to ensure a proper diagnosis.”
Also Read: Dementia: Warning Signs One Should Never Ignore
Distinguishing Factors To Note
Although both vitamin B12 and dementia have similar symptoms, they can be distinguished through a few key factors, as per Dr Pai. These include:
Causes for vitamin B12 deficiency
- Vitamin B12 deficiency is frequently observed in vegans and vegetarians and can be brought on by a diet low in B12.
- Certain disorders that prevent the body from absorbing vitamin B12, which include pernicious anaemia, Crohn's disease, and celiac disease, can be to blame.
- Long-term use of several drugs, such as metformin or proton pump inhibitors, may also cause problems with the absorption of vitamin B12.
Causes for dementia
- Dementia may result from Alzheimer's, Parkinson's, or other neurodegenerative diseases
- Vascular dementia may be brought on by a stroke or other vascular disorders of the brain.
- Specific pathological alterations in the brain cause dementia in conditions such as Lewy body dementia and frontotemporal dementia.
Treatment
When it comes to vitamin B12 deficiency, B12 supplements or dietary modifications can frequently reverse or greatly improve the symptoms. However, the majority of dementia types, including Alzheimer's disease, progress over time and are irreversible, Dr Pai noted. “Although there is no cure that totally reverses the illness, symptoms can be controlled,” she added.
Can Vitamin B12 Deficiency Be A Contributing Factors For Dementia Risk?
Research has indicated that insufficient levels of vitamin B12 may pose a potential risk factor for cognitive decline and brain atrophy, two conditions that are linked to dementia, Dr Pai shared, adding, “It's crucial to remember that, despite the correlation, the precise nature of the link between dementia and a vitamin B12 shortage is still unclear.”
However, explaining a few associations, she points to the link between elevated blood homocysteine levels and an increased risk of dementia and Alzheimer's disease. “Vitamin B12 aids in the body's breakdown of homocysteine, as does folate and other B vitamins like B6. Consequently, elevated homocysteine levels may result from a B12 shortage, raising the possibility of dementia,” she elaborated.
According to the doctor, elderly people, especially those over 50, should make sure they are getting enough vitamin B12 from their diet or supplements, especially if they are susceptible to a deficiency because of things like a vegan or vegetarian diet, gastrointestinal issues, or certain medications.
She concluded by saying that a healthy, vitamin B12-rich diet is crucial for maintaining the general health of the brain and may even lower the chance of dementia.
