title: Cobalamin and folate status predicts mental development scores in North Indian children 12-18 mo of age.
abstract: BACKGROUND
  Micronutrient deficiencies can affect cognitive function. Many young children in low- and middle-income countries have inadequate cobalamin (vitamin B-12) status.
  
  
  OBJECTIVE
  The objective was to measure the association of plasma concentrations of folate, cobalamin, total homocysteine, and methylmalonic acid with cognitive performance at 2 occasions, 4 mo apart, in North Indian children aged 12-18 mo.
  
  
  METHODS
  Bayley Scales of Infant Development II were used to assess cognition. In multiple regression models adjusted for several potential confounders, we measured the association between biomarkers for folate and cobalamin status and psychomotor or mental development scores on the day of blood sampling and 4 mo thereafter.
  
  
  RESULTS
  Each 2-fold increment in plasma cobalamin concentration was associated with a significant increment in the mental development index score of 1.3 (95% CI: 0.2, 2.4; P = 0.021). Furthermore, each 2-fold increment in homocysteine or methylmalonic acid concentration was associated with a decrement in mental development index score of 2.0 (95% CI: 0.5, 3.4; P = 0.007) or 1.1 (95% CI: 0.3, 1.8; P = 0.004) points, respectively. Plasma folate concentration was significantly and independently associated with mental development index scores only when children with poor cobalamin status were excluded, ie, in those who had cobalamin concentrations below the 25th percentile. None of these markers was associated with psychomotor scores in the multiple regression models.
  
  
  CONCLUSIONS
  Cobalamin and folate status showed a statistically significant association with cognitive performance. Given the high prevalence of deficiencies in these nutrients, folate and cobalamin supplementation trials are required to measure any beneficial effect on cognition.
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Tor A
authors.initials: TA
authors.lastname: Strand
authors.forename: Sunita
authors.initials: S
authors.lastname: Taneja
authors.forename: Per M
authors.initials: PM
authors.lastname: Ueland
authors.forename: Helga
authors.initials: H
authors.lastname: Refsum
authors.forename: Rajiv
authors.initials: R
authors.lastname: Bahl
authors.forename: Joern
authors.initials: J
authors.lastname: Schneede
authors.forename: Halvor
authors.initials: H
authors.lastname: Sommerfelt
authors.forename: Nita
authors.initials: N
authors.lastname: Bhandari
mesh_terms: D015415:Biomarkers / Q000097:blood; D002657:Child Development; D003072:Cognition Disorders / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D005494:Folic Acid Deficiency / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D006710:Homocysteine / Q000097:blood; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood; D055495:Neurogenesis; D009752:Nutritional Status; D015995:Prevalence; D011597:Psychomotor Performance; D014805:Vitamin B 12 / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D014806:Vitamin B 12 Deficiency / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D008764:Methylmalonic Acid; D005492:Folic Acid; D014805:Vitamin B 12