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All women have concerns about aging, and one of the most common is a possible decline in our cognitive function.  Many of my patients are worried about Alzheimer’s disease and want to know how it can be prevented.  Approximately one in five people over the age of 70 in the United States have mild cognitive impairment in which they experience problems with memory, language  or other mental functions.  Around half of them will go on to develop dementia, mainly Alzheimer’s within five years of diagnosis. The current research has been centered on the plaques and tangles in the brain which are thought to damage and kill nerve cells.  But a research team at the University of Oxford took a different approach—targeting the abnormal physical shrinkage of the brain.  They knew that a substance called homocysteine, an amino acid found in the blood, was associated with brain shrinkage.  The higher the level of homocysteine, the higher levels of brain shrinkage and increased risk of Alzheimer’s.  Folic acid, vitamin B6 and vitamin B12 control the levels of homocysteine in the blood. As we get older, the brain naturally shrinks in volume—as much as a half percent a year.  But in those with mild cognitive impairment, the brain can shrink by 1% per year and with Alzheimer’s by 2.5% per year. The research team recruited 168 volunteers over the age of 70 with diagnosed mild cognitive impairment.  All of the volunteers had a MRI to study brain shrinkage.  Then over a period of 2 years, half were given a daily tablet of high dose B vitamins (folic acid, vitamin B6 and vitamin B12).  The rest were given a placebo pill with no active ingredients.The results were remarkable.  On average, the group taking the B vitamins slowed the rate of brain atrophy by 30% and in some cases a reduction of up to 53% was noted.  In addition, the participants who started out with the highest rate of brain shrinkage had the best results.  Also, a strong association was observed between atrophy rate and retention of mental ability.The doses of B vitamins were much higher than obtained through diet or regular supplements.  The pills given contained 300X the recommended daily dose of B12, 4X the daily recommended folic acid and 15X the daily recommended amounts of B6.  The long term effects of taking high doses of the vitamins is not known and there is some evidence that high folic acid could be linked to cancer.The authors concluded that the accelerated rate of brain atrophy with mild cognitive impairment can be slowed by treatment with homocysteine lowering B vitamins.  More research is needed to determine whether the treatment could delay the development of Alzheimer’s disease.As a physician,  I find it difficult to argue against taking the high doses of vitamin B.  The vitamin B supplements are fairly safe, are not expensive and these results are convincing. ...read more