youtube.com/watch?feature=p...
Professor David Smith at the PAS conference 2013 begins to speak after about 4 minutes about low B12 and brain shrinkage and concludes :
"In the VITACOG trial, raising the median plasma B12 level from
330 to 672 pmol/L
largely prevented the atrophy of Alzheimer's related brain regions. It is clearly very important to maintain a VERY GOOD and not just an adequate, level of B12 ".
Judging by what I have read on this site, and my own experiences, A copy of this small section should be put up on every GPs office wall, where they can see it on a daily basis!!
I agree absolutely, Sorrelhippo. They are also meant to test levels but don't appear to do this, I watched a GP on TV recently tell a patient with very early dementia there was nothing she could do :
"Evaluating cognitive dysfunction requires involvement of family or other independent observers (not just the patient). "
"Lab testing B12 levels - Methylmalonic acid/homocysteine levels (confirm vitamin B12 deficiency). Potentially reversible syndromes:
- Depression
- Medication induced
- Metabolic derangements
- Vitamin B12 deficiency
- Thyroid disorders
- Thiamine deficiency
- Chronic disease (e.g., renal failure, hepatic failure, malignancy)"
"Laboratory testing should be considered to identify potentially reversible conditions that may mimic dementia. Early identification and aggressive management of such disorders may improve a patient’s thinking and daily function."
And another link.
onlinelibrary.wiley.com/doi...
A striking relationship between vitamin B12 and holoTC levels across the entire range (vitamin B12: 160–700 pmol L−1) was found for progressive brain atrophy over 5 year in a community population of 107 elderly: the lower the B12 status, the faster the brain atrophied [17]. "
When I worked as an Occupational Therapist there was a test called MEAMS, can no longer recall what all the letters stood for!! the first M I am sure was Middlesex, anyway this was very valuable as it was to help decide if a patient had dementia or depression, as these can be so difficult to tell apart, also it looked for specific cognitive losses. I used to invite the concerned relative to be present, providing they agreed to be out of the patient's vision, and to keep quiet (it is easy to "read" your daughter's face if you have given the wrong answer!!) Often the results were a shock to friends/relatives when they were clearly shown there were no memory issues.
I had to have some quite difficult conversations, when a relative would say, but he/she never remembers what I tell him/her. Often this was because they would rush in to collect a shopping list, and check what was needed, rush out, do the shopping, hurry back (they had their own familys to look after) and chat away whilst putting the shopping away. We all need to be able to concentrate and be interested, to "remember" what we remember. When I used to dig a bit about what was not remembered, it was chat about what the relative's neighbours/friends had been doing. It could be quite tricky to explain that, no-one is likely to remember chat, when they are distracted by other activities, but also they may not be interested in what your friends are doing, or certainly not enough to remember information given in passing!!
The other end of the scale, was a daughter who would not believe her Mum had a problem. This elderly lady had very good social skills, which can mask some problems. I had invited the daughter to meet me when I did the test, she met me at the door and said Mummy will remember your visit the other day, walked ahead of me into the sitting room and said " you do remember (my name) she came to see you last week" Mummy held out her hand to be shaken and said " of course I do, it is so nice to see you again" the daughter looked triumphant and said see I told you her memory was fine. The test proved there were severe memory problems, try explaining to someone that giving specific information and non-verbal cues would cover any memory problems. So much more could be done to investigate what is actually happening and why.
Thank you for sharing this sorrelhippo - so interesting....
I believe my sister's social skills covered up memory and cognitive problems for a long time too, even though her daughter suspected Alzheimer's. Our whole family went into denial.
It was only when her friend (also vegetarian, who'd had a diagnosis/B12 injections in the past) visited whilst sister was exhausted and bedbound again that, together, we managed to persuade her surgery to treat, albeit very reluctantly, with B12 injections. Sadly, it was a case of too little, too late as, although physical symptoms improved hugely, neuro/psychiatric problems became much worse, injections were stopped, and they would only treat with antipsychotics.
I do clearly remember though her telling me that psychiatrists would keep asking her if she was depressed ! She was the most mentally strong and least depressed of any of us before this.
I think there is a mental change in some older people, that can be labelled as "depression" which has little to do with the Reactive type we can see in people whe loose a loved one, or have a life changing event. Or the Endogenous type where some people just seem to be born with the chemical likelyhood of having what Churchill called "the black dog". I have seen it in my own relatives and some other older people. If they have had a long term and/or painful illness or a very hard life with losses, they seem to do a mental "life review" and work out if there is something more they want to see, a child getting married or a grandchild being born, and they almost seem to slow up when they feel they have got where they wanted to in life.
I think, when all other causes for this change are ruled out, like over medication, lack B12 or VitD, severe infection, dehydration, and many other possibilities, someone should be talking to them. Not someone saying "are you depressed" too many people, especially in the older generation, view this as a "bad" diagnosis, anyway how many of us would recognize it if we were? What it needs is a conversation about how they may be finding things more difficult then they used to, do they still look forward to going on holidays, do they still enjoy visitors, are they sleeping in more in the mornings, are they getting more fatigued. It just builds up a picture of mood. If you take the trouble to rule out the other possibilities, may be they are at where I mentioned at the start. Then at least we can see if there are ways we can ease the feelings, a volunteer to read to them, an interest they could persue even if they can no longer get out, Age UK now have a phone service where they offer a telephone "friend" who would call up once a week for a chat, for the very alone older person. I do agree that there are so many medical possibilities they have to be ruled out first.
There seems to be a generalised discrimination around older people, Oh well they do get slower, will have more illnesses, will become confused, so somehow we do not have to do the same worrying and med checks, as we would with a 20 year old with the same symptoms.
The VITACOG trial showed an improvement in those with raised homocysteine (>11).
(On Professor Smith's whiteboard) :
VITACOG
* In those with raised homocysteine (over 11), B vitamin treatment slowed atrophy of the Alzheimer's related brain regions by 90%.
* B vitamins also markedly slowed cognitive decline.
* Thus it is possible to SLOW DOWN THE DISEASE PROCESS LEADING TO ALZHEIMER'S DISEASE.
...................
Professor Smith then goes on to say, "This is a very important statement" !
Is serum folate levels the level of b12? 
B12 deficiency symptoms with good levels
High blood levels of B12
Serum B12 levels compared to active B12 levels 
Levels Of B12
