New literature regarding the pathophysiology plus the diagnostic and you can healing aspects of cobalamin deficiency are examined

Vitamin Ba dozen 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.

Alzhiemer’s disease is a generally going on disorder, particularly in elderly people populace. This new differential analysis of one’s alzhiemer’s disease syndromes includes many out of disorders, away from Alzheimer’s and you may alcoholic dementia so you’re able to posttraumatic and you can vascular alzhiemer’s disease. Hypovitaminosis is one of the partners conditions ultimately causing dementia which might be probably treatable today.

Dementia Of Vitamin B12 Deficit

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

Diligent step one. Diligent O.F., male, was known a medical facility at age 64 years on account of misunderstandings and you may collapse. Based on family unit members and acquaintances of really works, O.F. had found a slower progressive transform of behavior and you can damage out of performing overall performance because the an administrative personnel over the early in the day 5 years. Has just he had been in a position to do only the work out of a part-date worker, although the guy voluntarily has worked additional instances for the Saturdays. From time to time he had been sent house of functions due to confused address, walking obstacle, and you can failure to complete their really works accurately. Additionally, the guy exhibited a growing detachment away from societal products and you can a loss of profits interesting when you look at the prior passion.

For the admission to the hospital he had been conscious and you can collaborative, however, overwhelmed. The guy presented really serious disability regarding intellectual properties and quick-identity and you will enough time-title memories. Official thinking was slowed down. Drive, face term, spontaneous motions, and you will conceptual thinking element was quicker. He frequently complained off recollections deficits, and he got too little cravings ultimately causing an encumbrance loss of 11 kilogram during a period of 6 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.