{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:31:00Z","timestamp":1787160660614,"version":"build-2736575974"},"reference-count":30,"publisher":"BMJ","issue":"2","funder":[{"name":"Zuckerman-CHE Israeli Women Postdoctoral Scholarship"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Evid Based Mental Health"],"accepted":{"date-parts":[[2021,11,9]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between serum folate deficiency and the risk of dementia in old age is unclear, perhaps owing to small sample sizes, the competing risk of mortality or reverse causation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the associations between serum folate deficiency and the risks of incident dementia and all-cause mortality in a large national sample of older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort aged 60\u201375 years (n=27 188) without pre-existing dementia for at least 10 years, was tested for serum concentrations of folate and followed up for dementia or all-cause mortality. Serum folate deficiency was classified as present (&lt;4.4 ng\/mL), otherwise absent. HRs and 95% CIs from competing risks Cox models were fitted to quantify the associations between serum folate deficiency and the risks of dementia and all-cause mortality. To examine reverse causation, the analysis was stratified by duration of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The presence compared with the absence of serum folate deficiency was associated with higher risks of dementia (HR=1.68; 95% CI 1.32 to 2.13; p&lt;0.001) and all-cause mortality (HR=2.98; 95% CI 2.52 to 3.52; p&lt;0.001). Evidence for reverse causation were moderate for dementia and mild for all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Serum concentrations of folate may function as a biomarker used to identify those at risk of dementia and mortality; however, reverse causation is likely. Further research is needed to examine the role of serum folate deficiency in dementia aetiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical implications<\/jats:title>\n                    <jats:p>Serum folate deficiency in older adults requires monitoring and treatment for preventative measures and\/or as part of implemented therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ebmental-2021-300309","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T20:00:33Z","timestamp":1647374433000},"page":"63-68","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Serum folate deficiency and the risks of dementia and all-cause mortality: a national study of old age"],"prefix":"10.1136","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8634-9577","authenticated-orcid":false,"given":"Anat","family":"Rotstein","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arad","family":"Kodesh","sequence":"additional","affiliation":[{"name":"Department of Community Mental Health, University of Haifa, Haifa, Israel"},{"name":"Department of Mental Health, Meuhedet Health Services, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair","family":"Goldberg","sequence":"additional","affiliation":[{"name":"The Faculty of Industrial Engineering and Management, Technion\u2013Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Reichenberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA"},{"name":"Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5544-0420","authenticated-orcid":false,"given":"Stephen Z","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Community Mental Health, University of Haifa, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,3,15]]},"reference":[{"key":"2025082700010940000_25.2.63.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1994.tb00856.x"},{"key":"2025082700010940000_25.2.63.2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afg109"},{"key":"2025082700010940000_25.2.63.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.2006.tb00084.x"},{"key":"2025082700010940000_25.2.63.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5863.398"},{"key":"2025082700010940000_25.2.63.5","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.jalz.2015.05.016","article-title":"Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population\u2010based perspective","volume":"11","author":"Baumgart","year":"2015","journal-title":"Alzheimer's &amp; 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