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Homocysteine and Dementia: An International Consensus Statement
- Source :
- Journal of Alzheimer's Disease
- Publication Year :
- 2018
-
Abstract
- Identification of modifiable risk factors provides a crucial approach to the prevention of dementia. Nutritional or nutrient-dependent risk factors are especially important because dietary modifications or use of dietary supplements may lower the risk factor level. One such risk factor is a raised concentration of the biomarker plasma total homocysteine, which reflects the functional status of three B vitamins (folate, vitamins B12, B6). A group of experts reviewed literature evidence from the last 20 years. We here present a Consensus Statement, based on the Bradford Hill criteria, and conclude that elevated plasma total homocysteine is a modifiable risk factor for development of cognitive decline, dementia, and Alzheimer’s disease in older persons. In a variety of clinical studies, the relative risk of dementia in elderly people for moderately raised homocysteine (within the normal range) ranges from 1.15 to 2.5, and the Population Attributable risk ranges from 4.3 to 31%. Intervention trials in elderly with cognitive impairment show that homocysteine-lowering treatment with B vitamins markedly slows the rate of whole and regional brain atrophy and also slows cognitive decline. The findings are consistent with moderately raised plasma total homocysteine (>11 μmol/L), which is common in the elderly, being one of the causes of age-related cognitive decline and dementia. Thus, the public health significance of raised tHcy in the elderly should not be underestimated, since it is easy, inexpensive, and safe to treat with B vitamins. Further trials are needed to see whether B vitamin treatment will slow, or prevent, conversion to dementia in people at risk of cognitive decline or dementia.
- Subjects :
- 0301 basic medicine
Gerontology
Consensus
Homocysteine
Prevention of dementia
folate
vitamin B6
causation
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Cognition
Meta-Analysis as Topic
Risk Factors
Medicine
Dementia
Humans
Cognitive Dysfunction
Cognitive decline
Risk factor
cobalamin
cognitive impairment
business.industry
General Neuroscience
General Medicine
vitamin B12
medicine.disease
Psychiatry and Mental health
Clinical Psychology
B vitamins
Review Literature as Topic
risk-factor
030104 developmental biology
Editorial
chemistry
Relative risk
Attributable risk
Dietary Supplements
Vitamin B Complex
Geriatrics and Gerontology
business
Alzheimer’s disease
030217 neurology & neurosurgery
brain atrophy
Subjects
Details
- ISSN :
- 18758908 and 13872877
- Volume :
- 62
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of Alzheimer's disease : JAD
- Accession number :
- edsair.doi.dedup.....a6a97fe49536662e2317443a06ea1456