Folic acid supplementation in the elderly

• the FACIT trial provided evidence that daily folic acid supplementation for 3 years improved some aspects of cognitive function in older persons (1)
  • low folate and raised homocysteine concentrations in blood are associated with poor cognitive performance in the general population (1)
    • the FACIT trial to assessed the effect of folic acid on markers of atherosclerosis in men and women aged 50-70 years with raised plasma total homocysteine and normal serum vitamin B12 at screening,
    • the effect of folic acid supplementation on cognitive performance was included as a secondary endpoint in the study
    • randomly assigned 818 participants 800 mug daily oral folic acid or placebo for 3 years
    • 3-year change in memory (difference in Z scores 0.132, 95% CI 0.032 to 0.233), information processing speed (0.087, 0.016 to 0.158) and sensorimotor speed (0.064, -0.001 to 0.129) were significantly better in the folic acid group than in the placebo group
  • a commentary on this study however noted that "..several factors including the small effect size and strict criteria for inclusion limit the clinical relevance and generalisability of results.. "(2). The commentary also noted that "..the results of the FACIT trial may not apply to persons in the US and Canada where food is fortified with folic acid..."(2)

Reference:

1. Durga J et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet. 2007 Jan 20;369(9557):208-16.
2. Commentary. Evidence Based Medicine 2007;12:83.