Synopsis

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

Vitamin B9, particularly in its active form 5-methyltetrahydrofolate (5-MTHF), has been investigated for its potential role in supporting or treating dementia, including Alzheimer's disease. The scientific rationale is based on the observation that low folate levels are associated with elevated homocysteine, a risk factor for cognitive decline and neurodegeneration. Some studies have found that folate supplementation may reduce homocysteine levels, and observational data suggest an association between higher folate status and better cognitive performance in older adults.

However, randomized controlled trials (RCTs) testing folic acid or 5-MTHF supplementation have produced inconsistent results. While a few small studies indicate modest cognitive benefits, most large, high-quality RCTs have failed to show significant improvements in cognition or delay in progression of dementia with folate supplementation, even in populations with low baseline folate. Notably, the FACIT trial and others found no significant cognitive benefit, though subgroups with low folate or elevated homocysteine may derive some advantage.

Current evidence does not support routine use of Vitamin B9 (5-MTHF) for dementia treatment or prevention in the general population, but correcting a documented deficiency is important for overall neurological health. Thus, while there is a scientific basis for investigation, the evidence for efficacy in dementia is limited and inconsistent, justifying a moderate-low rating (2/5).

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