Cerebrospinal fluid (CSF) and serum levels of cobalamin were studied in 35 subjects with dementia and in 7 healthy volunteers with no clinical or family history of dementia. The demented patients were classified into three groups according to DSM-III-R: dementia of Alzheimer-type (DAT), multi-infarct dementia (MID) and dementia not otherwise specified (DNOS). The CSF concentrations of cobalamin were significantly reduced in the DAT and MID cases. There were correlations between CSF and serum levels of cobalamin in the patient groups. The cobalamin levels in CSF were not related to cognitive functioning, behavior or degree of dementia, respectively. The subarachnoid spaces, ventricles and white-matter changes in the brain were observed on magnetic resonance imaging. The volumes were calculated in the DAT group, but there were no correlations to CSF or serum concentrations of cobalamin. The significance of low CSF cobalamin is discussed in relation to the metabolism of the brain.
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