Japanese researchers conclude that folic acid supplementation may prevent the incidence of pneumonia. Older people often have difficulty swallowing and this problem in turn may lead to the development of aspiration pneumonia. Researchers at the Tohoku University School of Medicine now report that supplementation with folic acid is highly effective in preventing pneumonia. Their clinical trial involved 15 institutionalized patients who had been diagnosed with aspiration pneumonia on at least two separate occasions during the preceding two years. The patients, with an average age of 71 years, were matched with a control group of 12 healthy 72-years-olds with no history of pneumonia. The researchers measured baseline levels of folic acid, vitamin B12, vitamin B6, and homocysteine in the two groups. Thirteen of the 15 in the pneumonia group were found to be deficient in folic acid (average plasma level of 2.4 ng/mL versus 8.3 ng/mL in the controls). The patients also had excessively high homocysteine levels (18.2 micromol/L versus 6.4 micromol/L for the controls). There were no significant differences in vitamin B6 or vitamin B12 levels. However, the patients took significantly longer to swallow – average of 6 seconds versus 1.8 seconds for the controls. The patients then received a 5-mg folic acid tablet twice a day for eight weeks. At the end of this period their homocysteine and folate (folic acid) levels were normal and their swallowing reflex had improved to 1.7 seconds (equivalent to the controls). The supplementation was continued for two years during which time not a single case of pneumonia was observed. The researchers conclude that folic acid supplementation may prevent the incidence of pneumonia and improve swallowing function in older people.
Sato, Emi, et al. Folate deficiency and risk of pneumonia in older people. Journal of the American Geriatrics Society, Vol. 49, December 2001, pp. 1739-40 (letter to the editor)