As senior people’s life expectancy has increased, so has the prevalence of cardiovascular and cerebrovascular disorders in this demographic. All kinds of cognitive problems related to cerebrovascular illness are referred to as vascular cognitive impairment. Recently, homocysteine has been identified as a contributor to the pathomechanisms implicated in cognitive impairment. B vitamins, such as folic acid, have been shown to reduce homocysteine levels.

A comprehensive review and meta-analysis of studies on folic acid therapies for vascular cognitive impairment were carried out. Only randomized controlled trials studies comparing the efficacy of folic acid with placebo or other therapies were evaluated, regardless of publication status, year of publication, or language. 2 independent reviewers independently rated the included papers after searching the Medline through Ovid, EMBASE, and Cochrane Central Register of Controlled Trials (Central) journal databases up to July 2021. Researchers calculated the change in Mini-Mental State Examination, cognitive function domain, and homocysteine concentration using mean difference results with 95% confidence intervals (CI).

They discovered three trials that compared folic acid to placebo and 1 research that compared folic acid to other therapies. After 24 months, there was only a 0.3 point rise in the Mini-Mental State Examination score in patients who got folic acid compared to the placebo group (95% CI=0.12 to 0.37; P=.31). After 6 months, the levels of homocysteine in the folic acid group decreased by 6.16 mol/L compared to the placebo group (95% CI=2.32 to 8.21 lower; P<.001). The study found that folic acid was more efficient than placebo in lowering plasma homocysteine concentrations after 6 months. The impact, however, was not followed by an improvement in cognitive performance.