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In reply

We strongly disagree with Dr Fridman’s assertion that our results are attributable to a difference among the folate exposure groups in our ability to detect cognitive decline. The letter by Dr Fridman speaks to the very important issue that the measure used to assess cognitive change must be able to cover the full range of cognitive ability in the study population and must also be able to detect cognitive change over time at all levels of ability. Dr Fridman’s concern was that there was a floor effect in the cognitive scores for persons in the lowest quintile of folate intake, meaning that the test scores for this group were the lowest possible at the baseline and therefore any further decline at subsequent testing periods could not be measured. Most single tests are insensitive to measuring change at 1 of the cognitive extremes. Therefore, we combined the 4 cognitive . . . [Full Text of this Article]

AUTHOR INFORMATION

Martha Clare Morris, ScD; Julia L. Bienias, ScD; Liesi E. Hebert, ScD; Denis A. Evans, MD; Paul A. Scherr, PhD, ScD; Christine C. Tangney, PhD; Julie A. Schneider, MD

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High Folic Acid Intake Is Not a Risk Factor for Cognitive Decline: Misinterpretation of Results
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