This story provided insightful information about whether there exists an associations between the intake of specific B vitamins, including B6, folic acid (B9), and B12 (cobalamin), and chance of developing dementia or Alzheimer’s disease, this story is a very well organized discussion about what is and is not known about these vitamins, the levels of the amino acid homocysteine, and age-related or disease related cognitive impairment. The story never explained why this information was being reported at the current time, but it did provide a well considered look at the research on a complicated topic.
As the population ages, we are feeling the effects of cognitive decline in large numbers of people. Most families have been affected in some way by Alzheimer’s or a similar condition. A simple solution like B vitamins would provide hope for many, and stories like this provide readers a welcome analysis of the true basis for that hope.
There was no discussion of costs. Were people to begin taking B vitamins in the quantities necessary to show improvement along the lines of what has been seen in some of the studies mentioned, B vitamins could become a lifelong treatment with significant cumulative costs.
The slant of the story was to question the wisdom in augmenting vitamin B intake in light of the studies failing to demonstrate benefit. The story itself, however, reported on several pieces of evidence over time rather than reporting on the results of a specific study or studies. Where it did provide numbers on benefits, it did so in a clear and cautious way. For example, it noted “a recent study in which brain atrophy (or shrinkage, which occurs in older people who are losing brain function) slowed by 30% in elderly patients with both high homocysteine levels and mild cognitive impairment who took a B vitamin pill daily for two years. Brain shrinkage occurred at a rate of about 0.75% in the people taking B vitamins in the study, compared with a rate of 1.1% per year in a group that took a placebo.” By including the actual percentages for people in both groups, the story shows the reader that the shrinkage was not dramatic to begin with and that the difference between the two groups could also be described as a 0.26 percentage point difference.
The story did include information about possible side effects and harms associated with excessive consumption of B vitamins.
The story provided a reasonable description of several studies in which outcomes were not changed with vitamin B supplementation. There was a useful quote by one of the researches indicating that only a minority of studies showed any indication of benefit from increasing vitamin B intake. We wish it had taken a little more care in making clear distinctions between the different populations being studied. In some cases, the studies were focused on anyone of advanced age, while in others they were focused specifically on Alzheimer’s patients, but there was no discussion in the story about whether these differences may also have accounted for the different findings among the studies.
The story did not engage in disease mongering.
The story detailed several studies of the relation between the B vitamins and cognitive impairment; it included quotes from two researchers (Haan and Miller) in the field who are at different institutions but have several studies that they have worked on and published together.
There was no discussion of how the fortification of common foods in the supply chain, such as grains, flour, cereal, energy bars and drinks, has affected the levels of B vitamin. There was also no mention of other specific therapies to stop cognitive decline.
The story described the urge to rush out and purchase B vitamins, which is suggestive of their ready availability. The story neglected to mention that many foods are already fortified with B vitamins, which may already cover the recommended intake levels for many readers.
This story provided a nice overview of what is known about B vitamins in relation to age- and disease- related cognitive decline.
The story does not appear to rely solely on a news release. It is not clear why this information about the long-term research interest of two local scientists is news right now, but it is an interesting piece nonetheless.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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