- With Mayo Clinic geriatrician
Paul Y. Takahashi, M.D.
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Paul Y. Takahashi, M.D.
Paul Y. Takahashi, M.D.
"The Internet will impact the lives of all patients young and old. Older and mature patients are no exception to this information explosion." — Dr. Takahashi
Dr. Paul Yoshio Takahashi works with elderly patients as a member of the geriatric consultative group at Mayo Clinic. He works in all medical settings, including the outpatient clinic, the hospital, the nursing home and occasionally the patient's home. He is especially interested in strategies for successful aging, preventing elder abuse and mistreatment, and cognitive screening in elderly patients.
Dr. Takahashi is a consultant, Department of Medicine, Division of Community Medicine, at Mayo Clinic. He is an assistant professor of medicine at Mayo Clinic College of Medicine and a fellow of the American College of Physicians. He had a fellowship in geriatric medicine at Mayo Graduate School of Medicine from 1997 to 1998.
Dr. Takahashi cares for all of a patient's acute needs and chronic problems and focuses on specialty issues such as memory problems, safety in the home, healthy aging, proper medications and end-of-life concerns.
He sees the Internet playing a growing role in the health information field.
"Patients and their families want and expect the most up-to-date information about life, health, disease and death. Healthy aging as a concept has grown quickly over the last 20 years as we have all lived longer and hopefully better," he says. "I expect that Mayo Clinic will be a significant part of this growing movement of a healthy maturity."
Dr. Takahashi, a native of Pittsfield, Ill., joined Mayo Clinic in 1998 and is board certified in internal medicine with added qualification in geriatric medicine. He is a fellow of the American Geriatrics Society.
Risk factors (2)
- Alzheimer's: Can a head injury increase my risk?
- Oophorectomy (ovary removal): A risk factor for dementia?
Symptoms (1)
- Sundowning: Late-day confusion
Tests and diagnosis (2)
- Rapid-onset Alzheimer's: Could it be something else?
- Alzheimer's test: Detection at the earliest stages
Complications (1)
- Phantosmia: What causes olfactory hallucinations?
Treatments and drugs (4)
- Folic acid supplements: Can they slow cognitive decline?
- Alzheimer's nose spray: New Alzheimer's treatment?
- Vitamin B-12: Can it improve memory in Alzheimer's?
- see all in Treatments and drugs
Alternative medicine (4)
- Axona: Medical food to treat Alzheimer's
- Phosphatidylserine supplements: Can they improve memory?
- Vitamin B-12: Can it improve memory in Alzheimer's?
- see all in Alternative medicine
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Question
Folic acid supplements: Can they slow cognitive decline?
I've heard that folic acid supplements can improve cognitive function in older adults. Could those with Alzheimer's disease also benefit from folic acid?
Answer
from Paul Y. Takahashi, M.D.
There's no conclusive evidence that folic acid supplements improve cognitive function in older adults or in people with Alzheimer's disease or other types of dementia.
The study to which you may be referring assessed the effect of folic acid supplements on cognitive performance in 818 older adults with deficient blood levels of folate. Low folate levels are associated with poor cognitive performance in the general population.
Participants were randomly assigned to take 800 micrograms of folic acid or a placebo for three years. The study, which published in January 2007, showed cognitive function was significantly better in those who took folic acid supplements than in those who did not.
However, again, the participants in this study were already at some risk of cognitive decline because of deficient blood levels of folate. So the results of this study can neither be generalized to all older adults nor to those with Alzheimer's disease.
A 2008 review of eight randomized, controlled trials found that the use of folic acid supplements has no benefit on cognitive function in healthy adults or in those with mild to moderate cognitive decline or dementia.
So although it doesn't appear that everyone should take a folic acid supplement, it may be something worth discussing with your doctor. Keep in mind that if you live in the United States, many foods such as breads and cereals are fortified with folic acid. If you are at high risk of developing dementia or have already experienced some cognitive decline, checking your folic acid levels may be a reasonable next step.
Next questionAlzheimer's nose spray: New Alzheimer's treatment?
- Durga J, et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: A randomised, double blind, controlled trial. The Lancet. 2007;369:208.
- Malouf R, et al. Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. Cochrane Database of Systematic Reviews. 2008:CD004514.
- Bauer BA (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2009.
- Takahashi PY (expert opinion). Mayo Clinic, Rochester, Minn. March 22, 2009.
