1887
Volume 2025, Issue 4
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Cognitive health, crucial for the independence and quality of life in older adults, is influenced by various factors, including nutritional status, which is increasingly recognized for its importance. Folate (vitamin B9) and cobalamin (vitamin B12) are essential for neurological health. Despite most studies offering broad global insights, this research addresses the knowledge gap regarding the relationship between folate and cobalamin levels and cognitive memory performance in a cognitively healthy aging adult. The primary objective of this study is to examine the relationship between memory performance and blood levels of folate and cobalamin, as well as to identify the determinants of memory performance, in adults in Qatar.

We conducted a cross-sectional analysis of the data obtained from Qatar Biobank. This study assessed cognitive performance using the Cambridge Neuropsychological Test Automated Battery and measured blood concentrations of folate and cobalamin. Additionally, we examined demographic, lifestyle, behavioral, and disease-related factors as determinants of memory performance. We used multivariable linear regression to identify associations between Paired Associated Learning First Attempt Memory (PALFAMS) and vitamin levels.

Six hundred and thirty-six individuals aged 40 years and older were included in this study. The z-scores for blood levels of folate and cobalamin were each found to be positively associated with the PALFAMS (β, 0.17 [95% CI, −0.188 to 0.538]; = 0.334 and β, 0.19 [95% CI, −0.15 to 0.53]; = 0.28, respectively), after adjustment for covariates. Older age and being male were found to have negative associations with PALFAMS (β, −0.10 [95% CI, −0.18 to −0.02]; = 0.011 and β, −0.98 [95% CI, −1.91 to −0.05]; = 0.040, respectively), whereas a higher level of education and the use of supplements showed positive associations with memory function (β, 3.76 [95% CI, 2.38 to 5.14]; < 0.001 and β, 0.76 [95% CI, 0.02 to 1.50]; = 0.044), after adjustment for covariates.

Since the associations between blood levels of folate and cobalamin and memory performance were not statistically significant, these results underscore the need for more comprehensive studies to explore the complex relationships between nutrition and memory performance, ultimately guiding more effective strategies for the prevention and management of memory impairment.

© 2025 Akram, Masoodi, Abd Ur Rehman, Shi, Abdel-Rahman, licensee HBKU Press.
Loading

Article metrics loading...

/content/journals/10.5339/qmj.2025.109
2025-12-10
2025-12-13

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/qmj/2025/4/qmj.2025.109.html?itemId=/content/journals/10.5339/qmj.2025.109&mimeType=html&fmt=ahah

References

  1. Sachdev PS, Blacker D, Blazer DG, Ganguli M, Jeste DV, Paulsen JS, et al. Classifying neurocognitive disorders: the DSM-5 approach. Nat Rev Neurol. 2014 Nov; 10(11):634–42. https://doi.org/10.1038/nrneurol.2014.181
     [Google Scholar]
  2. Wallin A, Kettunen P, Johansson PM, Jonsdottir IH, Nilsson C, Nilsson M, et al. Cognitive medicine - a new approach in health care science. BMC Psychiatry. 2018 Feb; 18(1):42. https://doi.org/10.1186/s12888-018-1615-0
     [Google Scholar]
  3. Josefsson M, de Luna X, Pudas S, Nilsson LG, Nyberg L. Genetic and lifestyle predictors of 15-year longitudinal change in episodic memory. J Am Geriatr Soc. 2012 Dec; 60(12):2308–12. https://doi.org/10.1111/jgs.12000
     [Google Scholar]
  4. Nyberg L, Lövdén M, Riklund K, Lindenberger U, Bäckman L. Memory aging and brain maintenance. Trends Cogn Sci. 2012 May; 16(5):292–305. https://doi.org/10.1016/j.tics.2012.04.005
     [Google Scholar]
  5. Emmady PD, Schoo C, Tadi P. Major Neurocognitive Disorder (Dementia). StatPearls. Treasure Island, FL: StatPearls Publishing LLC.; 2023.
     [Google Scholar]
  6. Langa KM. Cognitive aging, dementia, and the future of an aging population. National Academies of Sciences, Engineering, and Medicine,Division of Behavioral and Social Sciences and Education; Committee on Population, editor . Future Directions for the Demography of Aging: Proceedings of a Workshop. Washington, DC: National Academies Press (US); 2018 Jun 26.
     [Google Scholar]
  7. Dominguez LJ, Veronese N, Vernuccio L, Catanese G, Inzerillo F, Salemi G, et al. Nutrition, physical activity, and other lifestyle factors in the prevention of cognitive decline and dementia. Nutrients. 2021 Nov; 13(11):4080. https://doi.org/10.3390/nu13114080
     [Google Scholar]
  8. Benito-León J, Ghosh R, Lapeña-Motilva J, Martín-Arriscado C, Bermejo-Pareja F. Association between cumulative smoking exposure and cognitive decline in non-demented older adults: NEDICES study. Sci Rep. 2023 Apr; 13(1):5754. https://doi.org/10.1038/s41598-023-32663-9
     [Google Scholar]
  9. Listabarth S, Groemer M, Waldhoer T, Vyssoki B, Pruckner N, Vyssoki S, et al. Cognitive decline and alcohol consumption in the aging population-a longitudinal analysis of the Survey of Health, Ageing and Retirement in Europe. Eur Psychiatry. 2022; 65(1):e83. https://doi.org/10.1192/j.eurpsy.2022.2344
     [Google Scholar]
  10. Gao F, Wei S, Dang L, Gao Y, Gao L, Shang S, et al. Sleep disturbance is associated with mild cognitive impairment: a community population-based cross-sectional study. BMC Public Health. 2022 Nov; 22(1):2000. https://doi.org/10.1186/s12889-022-14391-3
     [Google Scholar]
  11. Feinkohl I, Lachmann G, Brockhaus WR, Borchers F, Piper SK, Ottens TH, et al. Association of obesity, diabetes and hypertension with cognitive impairment in older age. Clin Epidemiol. 2018 Jul; 10853–62. https://doi.org/10.2147/CLEP.S164793
     [Google Scholar]
  12. Puri S, Shaheen M, Grover B. Nutrition and cognitive health: a life course approach. Front Public Health. 2023 Mar; 111023907. https://doi.org/10.3389/fpubh.2023.1023907
     [Google Scholar]
  13. Edward M. Modern Nutrition in Health and Disease. Philadelphia: Lippincott Williams & Wilkins; 2006. Available from: https://www.ncbi.nlm.nih.gov/nlmcatalog/101248134
     [Google Scholar]
  14. Lykstad J, Sharma S. Biochemistry, Water Soluble Vitamins. In: StatPearls. 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538510/
     [Google Scholar]
  15. Watanabe F. Vitamin B12 sources and bioavailability. Exp Biol Med (Maywood). 2007 Nov; 232(10):1266–74. https://doi.org/10.3181/0703-MR-67
     [Google Scholar]
  16. NIH . Office of Dietary Supplements - Vitamin B6; 2023. Available from: https://ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/.
     [Google Scholar]
  17. Wang Q, Zhao J, Chang H, Liu X, Zhu R. Homocysteine and folic acid: risk factors for Alzheimer’s disease-an updated meta-analysis. Front Aging Neurosci. 2021 May; 13665114. https://doi.org/10.3389/fnagi.2021.665114
     [Google Scholar]
  18. Gauthier S, Rosa-Neto P, Morais JA, Webster C. World Alzheimer Report 2021: journey through the diagnosis of dementia. Alzheimers Dis Int. 2021; 202230.
     [Google Scholar]
  19. Nichols E, Steinmetz JD, Vollset SE, Fukutaki K, Chalek J, Abd-Allah F, et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health. 2022 Feb; 7(2):e105–e25. https://doi.org/10.1016/S2468-2667(21)00249-8
     [Google Scholar]
  20. Qassem T, Itani L, Nasr W, Al-Ayyat D, Javaid SF, Al-Sinawi H. Prevalence and economic burden of dementia in the Arab world. BJPsych Open. 2023 Jul; 9(4):e126. https://doi.org/10.1192/bjo.2023.517
     [Google Scholar]
  21. Ministry of Public Health . Qatar National Dementia Plan 2018-2022: Summary. 2018.
     [Google Scholar]
  22. Lenehan ME, Summers MJ, Saunders NL, Summers JJ, Vickers JC. Does the Cambridge Automated Neuropsychological Test Battery (CANTAB) distinguish between cognitive domains in healthy older adults? Assessment. 2016 Apr; 23(2):163–72. https://doi.org/10.1177/1073191115581474
     [Google Scholar]
  23. Al Kuwari H, Al Thani A, Al Marri A, Al Kaabi A, Abderrahim H, Afifi N, et al. The Qatar Biobank: background and methods. BMC Public Health. 2015 Dec; 151208. https://doi.org/10.1186/s12889-015-2522-7
     [Google Scholar]
  24. Ferreira D, Correia R, Nieto A, Machado A, Molina Y, Barroso J. Cognitive decline before the age of 50 can be detected with sensitive cognitive measures. Psicothema. 2015; 27(3):216–22. https://doi.org/10.7334/psicothema2014.192
     [Google Scholar]
  25. Karlsen RH, Karr JE, Saksvik SB, Lundervold AJ, Hjemdal O, Olsen A, et al. Examining 3-month test-retest reliability and reliable change using the Cambridge Neuropsychological Test Automated Battery. Appl Neuropsychol Adult. 2022 Mar-Apr; 29(2):146–54. https://doi.org/10.1080/23279095.2020.1722126
     [Google Scholar]
  26. Winer JR, Deters KD, Kennedy G, Jin M, Goldstein-Piekarski A, Poston KL, et al. Association of short and long sleep duration with amyloid-β burden and cognition in aging. JAMA Neurol. 2021 Oct; 78(10):1187–96. https://doi.org/10.1001/jamaneurol.2021.2876
     [Google Scholar]
  27. WHO . Global Adult Tobacco Survey: Factsheet Qatar 2013; 2013. Available from: https://www.psa.gov.qa/en/statistics/Surveys/GATS-BOOK.pdf. Accessed March 22, 2024.
     [Google Scholar]
  28. Jetté M, Sidney K, Blümchen G. Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clin Cardiol. 1990 Aug; 13(8):555–65. https://doi.org/10.1002/clc.4960130809
     [Google Scholar]
  29. Centers for Disease Control and Prevention . About Adult BMI. Centers for Disease Control and Prevention; 2022.
     [Google Scholar]
  30. World Health Organization . Hypertension. World Health Organization; 2023.
     [Google Scholar]
  31. American Diabetes Association . Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014 Jan; 37 Suppl 1:S81–90. https://doi.org/10.2337/dc14-S081
     [Google Scholar]
  32. Martinez-Hervas S, Ascaso JF. Hypercholesterolemia. Huhtaniemi I, Martini L. Encyclopedia of Endocrine Diseases. 2nd Ed. Oxford: Academic Press; 2019. 320–6.
     [Google Scholar]
  33. National Institutes of Health . Office of Dietary Supplements - Folate; 2022. https://ods.od.nih.gov/.
     [Google Scholar]
  34. Duthie SJ, Whalley LJ, Collins AR, Leaper S, Berger K, Deary IJ. Homocysteine, B vitamin status, and cognitive function in the elderly. Am J Clin Nutr. 2002 May; 75(5):908–13. https://doi.org/10.1093/ajcn/75.5.908
     [Google Scholar]
  35. Ueno A, Hamano T, Enomoto S, Shirafuji N, Nagata M, Kimura H, et al. Influences of vitamin B12 supplementation on cognition and homocysteine in patients with vitamin B12 deficiency and cognitive impairment. Nutrients. 2022 Apr; 14(7):1494. https://doi.org/10.3390/nu14071494
     [Google Scholar]
  36. Abbott RA, Skirrow C, Jokisch M, Timmers M, Streffer J, van Nueten L, et al. Normative data from linear and nonlinear quantile regression in CANTAB: cognition in mid-to-late life in an epidemiological sample. Alzheimers Dement (Amst). 2018 Nov; 1136–44. https://doi.org/10.1016/j.dadm.2018.10.007
     [Google Scholar]
  37. Arevalo-Rodriguez I, Smailagic N, Roqué IFM, Ciapponi A, Sanchez-Perez E, Giannakou A, et al. Mini-Mental State Examination (MMSE) for the detection of Alzheimer’s disease and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev. 2015 Mar; 2015(3):CD010783. https://doi.org/10.1002/14651858.CD010783.pub2
     [Google Scholar]
  38. Ciesielska N, Sokołowski R, Mazur E, Podhorecka M, Polak-Szabela A, Kdziora-Kornatowska K. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr Pol. 2016 Oct; 50(5):1039–52. https://doi.org/10.12740/PP/45368
     [Google Scholar]
  39. Kueper JK, Speechley M, Montero-Odasso M. The Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog): modifications and responsiveness in pre-dementia populations. A narrative review. J Alzheimers Dis. 2018; 63(2):423–44. https://doi.org/10.3233/JAD-170991
     [Google Scholar]
  40. Mahendran R, Chua J, Feng L, Kua EH, Preedy VR. Chapter 109 - The mini-mental state examination and other neuropsychological assessment tools for detecting cognitive decline. Martin CR, Preedy VR. Diet and Nutrition in Dementia and Cognitive Decline. San Diego: Academic Press; 2015. 1159–74.
     [Google Scholar]
  41. Cheng D, Kong H, Pang W, Yang H, Lu H, Huang C, et al. B vitamin supplementation improves cognitive function in the middle aged and elderly with hyperhomocysteinemia. Nutr Neurosci. 2016 Dec; 19(10):461–6. https://doi.org/10.1179/1476830514Y.0000000136
     [Google Scholar]
  42. Murman DL. The impact of age on cognition. Semin Hear. 2015 Aug; 36(3):111–21. https://doi.org/10.1055/s-0035-1555115
     [Google Scholar]
  43. Domínguez-López I, Casas R, Chiva-Blanch G, Martínez-González M, Fitó M, Ros E, et al. Serum vitamin B12 concentration is associated with improved memory in older individuals with higher adherence to the Mediterranean diet. Clin Nutr. 2023 Dec; 42(12):2562–8. https://doi.org/10.1016/j.clnu.2023.10.025
     [Google Scholar]
  44. Ma F, Zhou X, Li Q, Zhao J, Song A, An P, et al. Effects of folic acid and vitamin B12, alone and in combination on cognitive function and inflammatory factors in the elderly with mild cognitive impairment: a single-blind experimental design. Curr Alzheimer Res. 2019; 16(7):622–32. https://doi.org/10.2174/1567205016666190725144629
     [Google Scholar]
  45. Mungas D, Fletcher E, Gavett BE, Widaman K, Zahodne LB, Hohman TJ, et al. Comparison of education and episodic memory as modifiers of brain atrophy effects on cognitive decline: implications for measuring cognitive eserve. J Int Neuropsychol Soc. 2021 May; 27(5):401–11. https://doi.org/10.1017/S1355617720001095
     [Google Scholar]
  46. Pavlinac Dodig I, Krišto D, Luši Kalcina L, Pecoti R, Vali M, Ðogaš Z. The effect of age and gender on cognitive and psychomotor abilities measured by computerized series tests: a cross-sectional study. Croat Med J. 2020 Apr; 61(2):82–92. https://doi.org/10.3325/cmj.2020.61.82
     [Google Scholar]
  47. Pauls F, Petermann F, Lepach AC. Gender differences in episodic memory and visual working memory including the effects of age. Memory. 2013; 21(7):857–74. https://doi.org/10.1080/09658211.2013.765892
     [Google Scholar]
  48. Yeung LK, Alschuler DM, Wall M, Luttmann-Gibson H, Copeland T, Hale C, et al. Multivitamin supplementation improves memory in older adults: a randomized clinical trial. Am J Clin Nutr. 2023 Jul; 118(1):273–82. https://doi.org/10.1016/j.ajcnut.2023.05.011
     [Google Scholar]
  49. Fu J, Liu Q, Zhu Y, Sun C, Duan H, Huang L, et al. Circulating folate concentrations and the risk of mild cognitive impairment: a prospective study on the older Chinese population without folic acid fortification. Eur J Neurol. 2022 Oct; 29(10):2913–24. https://doi.org/10.1111/ene.15474
     [Google Scholar]
  50. Wang Z, Zhu W, Xing Y, Jia J, Tang Y. B vitamins and prevention of cognitive decline and incident dementia: a systematic review and meta-analysis. Nutr Rev. 2022 Mar; 80(4):931–49. https://doi.org/10.1093/nutrit/nuab057
     [Google Scholar]
  51. Klaming R, Annese J, Veltman DJ, Comijs HC. Episodic memory function is affected by lifestyle factors: a 14-year follow-up study in an elderly population. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2017 Sep; 24(5):528–42. https://doi.org/10.1080/13825585.2016.1226746
     [Google Scholar]
  52. Wang X, Cheng Z. Cross-sectional studies: strengths, weaknesses, and recommendations. Chest. 2020 Jul; 158(1):S65–S71. https://doi.org/10.1016/j.chest.2020.03.012
     [Google Scholar]
  53. Elston DM. Participation bias, self-selection bias, and response bias. J Am Acad Dermatol. 2021 Jun. https://doi.org/10.1016/j.jaad.2021.06.025
     [Google Scholar]
  54. Xu H, Wang S, Gao F, Li C. Vitamin B6, B9, and B12 intakes and cognitive performance in elders: National Health and Nutrition Examination Survey, 2011-2014. Neuropsychiatr Dis Treat. 2022 Mar; 18537–53. https://doi.org/10.2147/NDT.S337617
     [Google Scholar]
/content/journals/10.5339/qmj.2025.109
Loading
Assessing the determinants and association of cognitive memory performance with blood folate and cobalamin levels in Qatar’s healthy aging population
Qatar Medical Journal 2025, 109 (2025); https://doi.org/10.5339/qmj.2025.109
/content/journals/10.5339/qmj.2025.109
/content/journals/10.5339/qmj.2025.109
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): CANTAB, cobalamin, cognitive memory performance, folate and Qatar Biobank

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error