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Dementia Associated With Vitamin B₁₂ Deficiency

Presentation of Two Cases and Review of the Literature

Received August 19, 1999; revised October 1, 1999; accepted November 3, 1999. From the Departments of Psychiatry and Neurology, University of Munich, Munich, Germany. Address correspondence to Dr. Goebels, University of Munich, Klinikum Grosshadern, Department of Neurology, Marchioninistr. 15, D-81377 Munich, Germany; e-mail: Norbert.Goebels{at}LRZ.uni-muenchen.de

ABSTRACT

Vitamin B₁₂ deficiency has long been associated with a wide variety of hematological, neurological, and psychiatric disorders. The role of vitamin B₁₂ deficiency as one of the few treatable causes of dementia, however, is still controversial. The authors report on 2 elderly patients suffering from cognitive impairment and psychotic symptomatology probably related to cobalamin deficiency, who showed improvement after parenteral vitamin B₁₂ substitution. The literature concerning the pathophysiology and the diagnostic and therapeutic aspects of cobalamin deficiency is reviewed.

Key Words: Dementia • Vitamin B12 • Homocysteine • Methylmalonyl Acid

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