Poster session: Behavioural and psychological correlates of low levels of vitamin B 12 and folate in patients with dementia: a prospective study
Engelborghs, S. × Goeman, J. D'Hooge, Rudi Mariën, P. Saerens, J. Symons, A. Clement, F. Pickut, B.A. De Deyn, P.P. #
Journal of Neurology vol:250 issue:suppl.2 II/72
European Neurological Society edition:13 location:Istambul, Turkey date:14-18 June 2003
Objective: We set up a prospective study to test for possible correlations of decreased serum vitamin B12 and red cell folate levels with behavioural and psychological symptoms (BPSD) in a population of patients with Alzheimer's disease (AD) and frontotemporal dementia (FTD).
Background: Since associations between decreased folate and vitamin B12 levels and (worsening of) psychiatric symptoms and disorders have been described, an association with BPSD could be expected. However, studies in this domain are very sparse, produced conflicting results and only focused on AD and vitamin B12.
Design/methods: Patients with probable AD (N = 108) and probable FTD (N = 18) were included in this prospective study. Behaviour was assessed covering a period of 2 weeks prior to inclusion using a battery of behavioural assessment scales (Middelheim Frontality Score, Behavioural Pathology in Alzheimer's Disease Rating Scale (Behave-AD), Cohen-Mansfield Agitation Inventory (CMAI), Cornell Scale for Depression in Dementia). Blood sampling and determination of serum vitamin B12 and red cell folate levels were performed within a time frame of two weeks of inclusion.
Results: Besides a significant but weak negative correlation between levels of red cell folate and verbally agitated behaviours (CMAI verbally agitated behaviour cluster: r=-0.231, P=0.022), no other significant correlations were found in the AD patient group. In FTD patients however, we found statistically significant negative correlations of levels of vitamin B12 with psychosis (Behave-AD psychosis cluster: r=-0.696, P=O.OOI) and with the total score of the Behave-AD (r = -0.616, P = 0.006).
Conclusions: In AD patients, we only found a weak association of verbally agitated behaviour with low levels of red cell folate. Although psychotic symptoms are rather rare in patients with FTD, the significant negative correlation between serum levels of vitamin B12 and psychotic features could mean that FTD patients with low vitamin B12 are at risk for the development of psychosis.