Vitamin Bseveral deficiency has long been associated with a wide variety of hematological, neurological, and psychiatric disorders. The role of vitamin B12 deficiency as one of the few treatable causes of dementia, however, is still controversial. The authors report on 2 elderly patients suffering from cognitive impairment and psychotic symptomatology probably related to cobalamin deficiency, who showed improvement after parenteral vitamin B12 substitution.
Dementia is actually a typically taking place disorder, particularly in older people populace. This new differential medical diagnosis of the dementia syndromes is sold with a lot away from problems, out-of Alzheimer’s and you will alcoholic dementia so you can posttraumatic and vascular dementia. Hypovitaminosis is among the few problems leading to alzhiemer’s disease which can be probably treatable today.
Dementia With the Supplement B12 Deficiency
The following two case reports illustrate the importance of vitamin B12 deficiency as a possible cause for the development of dementia. They also underline that vitamin B12 deficiency is a frequent condition in the elderly population that is often overlooked in clinical practice. Whereas common routine parameters like the serum level of vitamin B12 or the Schilling test in deficiency, newer functional assays in B12 deficiency as a cofactor for dementia in the future.
Case Records
Patient 1. Diligent O.F., men, was regarded a hospital on period of 64 years on account of misunderstandings and you will collapse. Based on family and you can colleagues out of work, O.F. got revealed a slower modern change regarding choices and you may damage from performing efficiency given that an administrative worker across the previous five years. Recently he had been capable manage precisely the workload regarding a member-go out personnel, regardless if he voluntarily has worked more hours toward Saturdays. From time to time he had been sent home out of functions because of puzzled address, walking obstacle, and you may failure to complete their really works truthfully. In addition, he exhibited an ever-increasing detachment out-of personal activities and you can a loss of profits of interest in the past welfare.
To your admission to your health he was awake and collaborative, however, confused. He shown major handicap off cognitive characteristics and quick-identity and you may long-label memory. Official thinking is actually slowed down. Push, face expression, natural actions, and you may abstract convinced feature naughty kazakhstan chat room was in fact smaller. The guy seem to reported from recollections deficits, in which he had a lack of appetite causing a weight death of eleven kg during a period of six days.
Physical examination revealed a pale and dry skin and emphysematic lungs. The neurological examination showed diminished tendon reflexes and a reduced sense of posture and vibration of the legs. Primitive reflexes (palmomental and snout reflexes) were positive. CT scan and MRI of the brain showed a generalized cerebral atrophy. EEG, cerebrospinal fluid, Doppler sonography of the cerebral arteries, and xenon SPECT for the measurement of cerebral blood flow did not show any abnormalities. The serum vitamin B12 level was in the lower normal range (307 pg/ml). The red blood count was normal. The Schilling test was pathological (9% absorption of cobalamin), but normalized after substitution of intrinsic factor (18% absorption), indicating a lack of intrinsic factor. Gastroscopy revealed atrophic gastritis, which was confirmed by biopsy. Serum titers of antibodies specific for parietal cells were not elevated, however.
Detailed psychological testing (complete Wechsler Adult Intelligence Scale–Revised, Benton Visual Retention Test, Trail Making Test, and Mini-Mental State Examination [MMSE]) reflected an average overall IQ (102). Concentration and the ability to solve complex cognitive tasks were reduced, however. At the retest approximately 5 weeks later (under substitution of vitamin B12 and additional therapy with doxepin and lorazepam), the patient showed a significantly better performance IQ (112) and improved cognitive speed.
Patient 2. Patient A.H., male, was admitted to our psychiatric clinic at the age of 77 years. For the previous 13 years he had had the delusional fear of impoverishment. However, when he encountered special offers, he bought unnecessary amounts of cheap and often useless items, which he then collected in his apartment. For the past 11 years he had been known to suffer from pernicious anemia, yet he had only rarely accepted parenteral vitamin B12 substitutions.