Synopsis

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

Folic acid (vitamin B9) has been investigated for its potential role in supporting or treating dementia, particularly Alzheimer’s disease, due to its involvement in homocysteine metabolism and neuronal health. Scientific studies have shown that low folate levels are sometimes associated with cognitive decline and increased risk of dementia. Elevated homocysteine, which can result from folate deficiency, is considered a risk factor for vascular disease and possibly neurodegeneration. Some small randomized controlled trials and observational studies suggest that folic acid supplementation may slow cognitive decline, particularly in individuals with low baseline folate or high homocysteine levels.

However, the overall evidence is inconsistent and generally of low to moderate quality. Large, well-designed clinical trials have not consistently demonstrated a significant benefit of folic acid supplementation in preventing or treating dementia in the general population. Most clinical guidelines do not recommend routine folic acid supplementation for dementia except in cases of diagnosed deficiency. The mechanism by which folic acid could exert a protective effect is plausible—through reduction of homocysteine and support of methylation pathways—but conclusive evidence is lacking.

In summary, while there is a scientific rationale and some limited supporting evidence for the use of folic acid in dementia, the strength of evidence is modest (rated 2/5), and supplementation is not considered a validated or universally recommended therapy for dementia outside of specific deficiency states.

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