Dementia and Dietary Intake of Vitamin B6 and Vitamin B12 among Elderly Type 2 Diabetic Subjects Attending a Tertiary Care Hospital in Bangladesh

Abstract

Dementia and Type 2 Diabetes Mellitus (T2DM) are now parallel epidemics with hyperhomocysteinemia as one of the common links. Exploration of the dietary intake of vitamins B6 and B12 (important cofactors in homocysteine metabolism) is important in investigating the risk factors of dementia in various populations. To explore the association of dietary intake of vitamins B6 and B12 with dementia among Bangladeshi elderly type 2 diabetes mellitus subjects. A cross-sectional study, with purposive sampling, was conducted on 197 elderly T2DM (age >65 years) subjects. A structured questionnaire (Addenbroke's Cognitive Examination-ACEIII, validated for Bengali population), was used to estimate their ACE-III scores with subjects classified into Diabetic Nondementia (ND) (Score>75) and Diabetic Dementia (DD) (Score below 75) groups. Dietary intake of vitamins B6 and B12 were assessed by a predesigned 24hr recall method. The overall proportion of dementia was 65%; females were affected twice more as compared to males (46.2% vs. 93.6%, P<0.001). Females had significantly higher mean BMI (P=0.005) and proportion of obesity was also higher among them (P=0.008). Age and ACEIII score were negatively correlated (P=0.001). On multivariate analysis, female gender and age were found to be independent risk factors of dementia. On bivariate as well as on multivariate analysis, vitamins B6 and B12 did not show any significant association with dementia. About two-third of elderly diabetic persons in Bangladesh suffer from dementia and females are two times more affected than males. Age is an independent risk factor of dementia. Dietary deficiency of vitamins B6 and B12 do not seem to be independent risk factors for dementia in an urban setting; however, the findings need to be verified by large scale community-based studies.