The 2010 OPTIMA [Oxford Project to Investigate Memory and Ageing] study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6. This is an important finding, as 16 percent of individuals older than age 70 have mild cognitive impairment (MCI). 50 percent of whom realize further progression to Alzheimer’s disease. It is well-documented that brain atrophy is a characteristic of subjects with mild cognitive impairment who progress to Alzheimer’s disease.

Given the emerging importance of these B vitamins on the rate of brain atrophy after age 60, memory, cognition, and risk of MCI and Alzheimer’s disease, health care practitioners should consider evaluating plasma folate (more ideally using erythrocyte folate test), plasma B12 levels and total plasma homocysteine levels in patients over age 50 to identify those who would best benefit from supplementation with these three B vitamins. When warranted, a low dose of prevention may translate into many more years of normal cognitive function and preserved quality of life and dignity.