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63/100

✓ Peer-reviewed alzhub usefulness score 63 out of 100. Prevention and risk

Topic: Risk, prevention and care in population studies

Background Folate deficiency can result in congenital neural tube defects and megaloblastic anaemia. Folic acid supplements may sometimes therefore include vitamin B12 supplements with simultaneous administration of vitamin B12.Lesser degrees of folate inadequacy are associated with high blood levels of the amino acid homocysteine which has been linked with the risk of arterial disease, dementia and Alzheimer's disease. Selection criteria All double-blind, placebo-controlled, randomized trials, in which supplements of folic acid with or without vitamin B12 were compared with placebo for elderly healthy people or people with any type of dementia or cognitive impairment. Main results Eight randomized controlled trials fulfilled the inclusion criteria for this review. However, in one trial enrolling a selected group of healthy elderly people with high homocysteine levels, 800 mcg/day folic acid supplementation over three years was associated with significant benefit in terms of global functioning (WMD 0.05, 95% CI 0.004 to 0.096, P = 0.033); memory storage (WMD 0.14, 95% CI 0.04 to 0.24, P = 0.006) and information-processing speed (WMD 0.09, 95% CI 0.02 to 0.16, P = 0.016).Four trials involved people with cognitive impairment. In one pilot trial enrolling people with Alzheimer's disease, the overall response to cholinesterase inhibitors significantly improved with folic acid at a dose of 1mg/day (odds ratio: 4.06, 95% CI 1.22 to 13.53; P = 0.02) and there was a significant improvement in scores on the Instrumental Activities of Daily Living and the Social Behaviour subscale of the Nurse's Observation Scale for Geriatric Patients (WMD 4.01, 95% CI 0.50 to 7.52, P = 0.02). In a preliminary study, folic acid was associated with improvement in the response of people with Alzheimer's disease to cholinesterase inhibitors.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Malouf, R., & Grimley Evans, J. (2008). Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. The Cochrane database of systematic reviews. https://doi.org/10.1002/14651858.cd004514.pub2

Vancouver

Malouf R, Grimley Evans J. Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. The Cochrane database of systematic reviews. 2008. doi:10.1002/14651858.cd004514.pub2. PMID: 18843658.

BibTeX

@article{malouf2008-18843658,
  author  = {Malouf, R. and Grimley Evans, J.},
  title   = {{Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people}},
  journal = {The Cochrane database of systematic reviews},
  year    = {2008},
  doi     = {10.1002/14651858.cd004514.pub2},
  pmid    = {18843658},
  url     = {https://doi.org/10.1002/14651858.cd004514.pub2}
}

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Key findings

Background Folate deficiency can result in congenital neural tube defects and megaloblastic anaemia.
Folic acid supplements may sometimes therefore include vitamin B12 supplements with simultaneous administration of vitamin B12.Lesser degrees of folate inadequacy are associated with high blood levels of the amino acid homocysteine which has been linked with the risk of arterial disease, dementia and Alzheimer's disease.
Selection criteria All double-blind, placebo-controlled, randomized trials, in which supplements of folic acid with or without vitamin B12 were compared with placebo for elderly healthy people or people with any type of dementia or cognitive impairment.
Main results Eight randomized controlled trials fulfilled the inclusion criteria for this review.
However, in one trial enrolling a selected group of healthy elderly people with high homocysteine levels, 800 mcg/day folic acid supplementation over three years was associated with significant benefit in terms of global functioning (WMD 0.05, 95% CI 0.004 to 0.096, P = 0.033); memory storage (WMD 0.14, 95% CI 0.04 to 0.24, P = 0.006) and information-processing speed (WMD 0.09, 95% CI 0.02 to 0.16, P = 0.016).Four trials involved people with cognitive impairment.

Why it matters

In one trial of healthy elderly people with high homocysteine levels, 800 mcg/day folic acid over three years was associated with significant benefit in global functioning, memory storage, and information-processing speed. In a pilot trial of people with Alzheimer's disease, the overall response to cholinesterase inhibitors significantly improved with folic acid.

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Study details

Evidence strengthHigh

How this study scored 63/100

Published in a leading specialty journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.

Component	Points	Why
Journal tier	9 / 10	Tier 2 — leading specialty journal (The Cochrane database of systematic reviews)
Journal's citation record	3 / 4	Cochrane Database of Systematic Reviews: journal h-index 468 (OpenAlex, 2026-10-29)
Study design	12 / 12	A systematic review of all the studies on the question (from PubMed type “Systematic Review”)
Strength of evidence	5 / 5	Rated “high” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2008 — within 20 year(s) of the newest study here
Sample size	0 / 4	Participant count not stated — scores zero (not stated in the record — scored 0)
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	0 / 3	Not stated whether this was studied in people — scores zero (not stated in the record — scored 0)
Randomized / blinded	0 / 2	A review of other studies — randomization is not credited here
Times cited	5 / 7	Cited 278 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	13.9 citations a year over 20 year(s) since 2008
Impact for its field and year	4 / 6	Cited 16.3× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 13 other studies in this library
Still being cited	1 / 4	Cited 11 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	2 / 4	Last-listed author John Grimley Evans: h-index 27 (OpenAlex, whole career)
Institution's track record	2 / 3	University of Oxford: institution h-index 2,205 (OpenAlex)
Multicenter collaboration	1 / 3	OpenAlex lists 3 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 18843658)
Free to read	0 / 2	Behind a paywall — scores zero
Total	63 / 100	—

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