Older adults with vitamin B12 levels considered normal may still face cognitive decline and brain damage, according to a new study.
Participants with lower—yet technically acceptable—B12 levels showed measurable brain white matter damage and slower cognitive processing, prompting researchers to call for a reevaluation of what constitutes “healthy” B12 levels in aging populations.
These lower levels could “impact cognition to a greater extent than what we previously thought, and may affect a much larger proportion of the population than we realize,” Alexandra Beaudry-Richard, co-first author, said in a press release.
Rethinking B12 Levels
Recent research published in Annals of Neurology found that older, healthy people with concentrations of B12 in their blood on the lower side of normal showed signs of neurological and cognitive deficiency. The study found that lower B12 was linked to damage in the brain’s white matter, which helps brain regions communicate.
Researchers enrolled 231 healthy participants without dementia or mild cognitive impairment, with an average age of 71. Their average blood B12 level was 414.8 pmol/L, which exceeds the U.S. minimum threshold of 148 pmol/L, indicating that, on average, they do not exhibit B12 deficiency. Normal values for B12 are often cited as being roughly between 118 to 701 pmol/L.
Assessments of cognitive performance indicated that lower active B12 levels were associated with slower processing speeds, suggesting a potential for subtle cognitive decline. This effect was more pronounced in older participants.
The results raise questions about current B12 requirements and suggest the recommendations need updating, according to Dr. Ari J. Green, chief of the division of neuroimmunology and glial biology in the Department of Neurology at the University of California at San Francisco, and senior author of the study.
Older people are more prone to lower vitamin B12 levels because their stomach acid production, which is crucial for properly absorbing B12 from food, decreases as they age. This malabsorption, combined with potential dietary inadequacies, can lead to deficiency.
Low B12 levels are linked to brain lesions because B12 is vital for the health of nerve cells in the brain, so a deficiency can cause damage to the white matter, leading to lesions that can impact cognitive function.
“Previous studies that defined healthy amounts of B12 may have missed subtle functional manifestations of high or low levels that can affect people without causing overt symptoms,” Green stated.
“Revisiting the definition of B12 deficiency to incorporate functional biomarkers could lead to earlier intervention and prevention of cognitive decline,” he added.
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