Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Vitamin B12 (cyanocobalamin) is used in the context of dementia primarily due to its critical role in neurological function and the well-established consequences of B12 deficiency. Scientific evidence shows that severe vitamin B12 deficiency can cause neurological symptoms, including cognitive impairment and, in extreme cases, reversible dementia. Accordingly, correcting B12 deficiency in individuals with low B12 levels can lead to improvement or stabilization of cognitive symptoms. This has led to the routine practice of screening for and treating B12 deficiency in patients presenting with cognitive decline or dementia syndromes.

However, the evidence for using vitamin B12 supplementation to treat or prevent dementia in individuals without deficiency is limited and inconsistent. Large observational studies have shown an association between low B12 levels and cognitive impairment, but randomized controlled trials in unselected patients with dementia or mild cognitive impairment have not demonstrated significant cognitive benefits from B12 supplementation in those with normal or only borderline-low B12 levels. Systematic reviews and meta-analyses (e.g., Cochrane Reviews) generally conclude that there is insufficient evidence to support widespread B12 supplementation for dementia prevention or treatment outside of documented deficiency.

In summary, while there is strong scientific justification for correcting B12 deficiency in patients with cognitive symptoms, there is little evidence that supplementation benefits individuals with normal B12 levels. Therefore, the evidence rating for B12’s use in dementia is moderate when deficiency is present, but low when used more broadly.

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