About 5.8 million people in the U.S. have Alzheimer’s disease and related dementias, giving these life-altering illnesses a wide impact across the country. But while it can be devastating when a loved one shows signs of memory loss, doctors say you shouldn’t automatically assume they have dementia.
Several factors can cause a person to have classic signs of dementia, including a deficiency in vitamin B12. “Vitamin B12 deficiency can cause cognitive impairment, including impairments in thinking,” says Dr. Scott Kaiser, a geriatrician and director of Geriatric Cognitive Health for the Pacific Neuroscience Institute in Santa Monica, CA. “That can definitely mimic signs of dementia.”
Couple that with the fact that older adults are more likely to have trouble fully absorbing vitamin B12, putting them at risk for a deficiency, and doctors say that vitamin B12 deficiency should at least be on the radar of people with older loved ones. Unlike dementia, this is a health issue that can be reversed.
But what does a vitamin B12 deficiency look like, and how can you tell it apart from dementia? Doctors explain.
What is vitamin B12?
Vitamin B12 is a water-soluble vitamin that’s naturally present in some foods, although it’s also available as a dietary supplement and prescription medicine, according to the National Institutes of Health (NIH). This vitamin helps your body make DNA, and also plays a role in the development and function of the central nervous system, which includes the brain and spinal cord.
Your body can’t make vitamin B12, so you need to get it from outside sources like meat, dairy, eggs, fortified foods, and supplements, the NIH says. Most adults need 2.4 micrograms of vitamin B12 a day, although the numbers are slightly higher during pregnancy and breastfeeding.
Causes of vitamin B12 deficiency
There are a few reasons why someone might develop a vitamin B12 deficiency. Following a vegan diet for years is a big one, says Deborah Cohen, D.C.N., an associate professor in the department of clinical and preventive nutrition sciences at Rutgers University School of Health Professions. “Humans can store a small amount of vitamin B12,” which is why it may take a while for a deficiency to show up, she says.
But Cohen says there are plenty of other risk factors for vitamin B12 deficiency, including taking the diabetes drug metformin and certain medications for gastroesophageal reflux disease (GERD) like proton pump inhibitors for years. “These drugs decrease secretion of intrinsic factor—a protein secreted by cells in the stomach which is vital for the transport of B12 from the stomach to the last part of the small intestine, where it is absorbed,” Cohen explains.
People who have had stomach surgery for weight loss, older adults, and people with gastrointestinal conditions like Crohn’s disease and celiac disease are also at risk for a B12 deficiency, she says.
Vitamin B12 deficiency symptoms
Vitamin B12 deficiency has a few hallmark symptoms, according to doctors:
“B12 is essential for energy production,” says Dr. Amit Sachdev, medical director in the Department of Neurology at Michigan State University. “The most common manifestation of B12 deficiency is fatigue.” That fatigue and related symptoms can be confused with symptoms of depression and dementia, he says.
People with vitamin B12 deficiency may act forgetful and confused, and struggle with concentrating and accomplishing tasks, Kaiser says. In more severe vitamin B12 deficiencies, a person may develop delusions and paranoia. “That could mimic dementia,” Kaiser says.
How to tell a vitamin B12 deficiency from dementia symptoms
Doctors say it’s hard to tell from a physical exam if a person has a vitamin B12 deficiency or dementia. “There is no way to tell the difference based on [cognitive] symptoms,” says Parul M Goyal, M.D., assistant professor of medicine at Vanderbilt University Medical Center and director of Medicine for Seniors…
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