{"id":"a3972a1e-e7fb-5618-bc80-6ba49f5ab3cd","stable_key":"ec174d5a-4903-5745-8646-df0e9d4265e8:fol-b12-low-high-folate-cognition","predicate":"high_status_associated_with_low_cognitive_test_score_when_b12_low","statement":"High folate within low B12 status was associated with greater odds of cognitive impairment defined by Digit Symbol-Coding score below 34 (OR 2.6; 95% CI 1.1–6.1).","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"negative","is_public":true,"mechanism_event_id":"e21a13f4-2467-5676-8453-fb85bc86b100","mechanism_event_label":"The observed folate–cognition relationship depended on B12 status.","subject":{"id":"69fa9bd2-2d5e-5468-b810-496ee7effcfc","slug":"serum-folate-concentration","display_name":"Serum folate concentration","entity_type_key":"cellular_process"},"object":{"id":"50d49132-2142-559f-b045-71b707484da5","slug":"digit-symbol-coding-performance","display_name":"Digit Symbol-Coding performance","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"e21a13f4-2467-5676-8453-fb85bc86b100","stable_key":"ec174d5a-4903-5745-8646-df0e9d4265e8:fol-b12-low-high-folate-cognition-event","event_type":"observed_intervention","label":"The observed folate–cognition relationship depended on B12 status.","description":"High folate within low B12 status was associated with greater odds of cognitive impairment defined by Digit Symbol-Coding score below 34 (OR 2.6; 95% CI 1.1–6.1).","status":"provisional","compartment":null,"participants":[{"entity":{"id":"b6d9b937-895d-5e0a-8cc5-0454a0b7d373","slug":"vitamin-b12","display_name":"Vitamin B12 (cobalamins)","entity_type_key":"chemical_species"},"role":"status_modifier","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"69fa9bd2-2d5e-5468-b810-496ee7effcfc","slug":"serum-folate-concentration","display_name":"Serum folate concentration","entity_type_key":"cellular_process"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"50d49132-2142-559f-b045-71b707484da5","slug":"digit-symbol-coding-performance","display_name":"Digit Symbol-Coding performance","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"availability_state","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null},{"dimension":"cross_nutrient","value_text":"Does not prove folic acid worsens neurologic injury or that methylfolate resolves B12 deficiency.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Cross-sectional NHANES 1999–2002 sample of 1459 older adults with normal creatinine and specified clinical exclusions. Cognitive analysis n=1302.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Measured serum folate and B12/MMA; low B12 defined as serum B12 <148 pmol/L or MMA >210 nmol/L; high folate >59 nmol/L.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"An association in one test is not causal dementia evidence. In B12-normal participants, high folate was associated with lower impairment odds.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Folate and folic acid research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"folate","display_name":"Folate (vitamin B9)","entity_type_key":"chemical_species"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"The observed folate–cognition relationship depended on B12 status.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[fol-morris2007] Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification (2007). https://pubmed.ncbi.nlm.nih.gov/17209196/ DOI: 10.1093/ajcn/85.1.193","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Human blood or whole-person clinical endpoints","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"trigger_kind","value_text":"biomarker_context","comparator":null,"unit":null,"notes":"Imported condition classification; unverified.","entity":null}],"evidence":[{"id":"9f3a3836-f8ae-59be-a8e7-5de30c6dc243","evidence_kind":"source_excerpt","locator":"Lines 1554-1565","start_line":1554,"end_line":1565,"excerpt":"### fol-b12-low-high-folate-cognition\nHigh folate within low B12 status was associated with greater odds of cognitive impairment defined by Digit Symbol-Coding score below 34 (OR 2.6; 95% CI 1.1–6.1).\nCondition category: biomarker_context\nnutrient_topic: Folate and folic acid research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: The observed folate–cognition relationship depended on B12 status.\norganism: Homo sapiens\ntissue_or_cell_type: Human blood or whole-person clinical endpoints\nexperimental_model: Cross-sectional NHANES 1999–2002 sample of 1459 older adults with normal creatinine and specified clinical exclusions. Cognitive analysis n=1302.\nlimitations: An association in one test is not causal dementia evidence. In B12-normal participants, high folate was associated with lower impairment odds.\nexposure: Measured serum folate and B12/MMA; low B12 defined as serum B12 <148 pmol/L or MMA >210 nmol/L; high folate >59 nmol/L.\ncross_nutrient: Does not prove folic acid worsens neurologic injury or that methylfolate resolves B12 deficiency.\n[fol-morris2007] Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification (2007). https://pubmed.ncbi.nlm.nih.gov/17209196/ DOI: 10.1093/ajcn/85.1.193","model_system":"Cross-sectional NHANES 1999–2002 sample of 1459 older adults with normal creatinine and specified clinical exclusions. Cognitive analysis n=1302.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [fol-morris2007] Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification (2007). https://pubmed.ncbi.nlm.nih.gov/17209196/ DOI: 10.1093/ajcn/85.1.193","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"f4ce1a62-9582-5f7a-84f5-a23d0e1bfc68","stable_key":"import-ec174d5a-4903-5745-8646-df0e9d4265e8","title":"Folate and folic acid: mechanisms, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"e564d43989ece1006c95cd0748e9af6fe369074599a2eebba0a99ebff864b0dd","revision_id":"76674a33-b2a1-5e41-b71b-44399038ff7c","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}