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Significant correlations of plasma homocysteine and serum methylmalonic acid with movement and cognitive performance in elderly subjects but no improvement from short-term vitamin therapy: a placebo-controlled randomized study.
Am J Clin Nutr 2005; 81(5):1155-62AJ

Abstract

BACKGROUND

Deficiencies of vitamin B-12, folic acid, and vitamin B-6-as defined by laboratory measures-occur in 10-20% of elderly subjects. The clinical significance remains unresolved.

OBJECTIVE

The objective was to explore any association between vitamin status and vitamin treatment and movement and cognitive performance in elderly subjects.

DESIGN

Community-dwelling subjects (n = 209) with a median age of 76 y were randomly assigned to daily oral treatment with 0.5 mg cyanocobalamin, 0.8 mg folic acid, and 3 mg vitamin B-6 or placebo (double blind) for 4 mo. Movement and cognitive performance tests were performed before and after treatment.

RESULTS

A high plasma total homocysteine (tHcy) concentration (> or =16 micromol/L) was found in 64% of men and in 45% of women, and a high serum methylmalonic acid (MMA) concentration (> or =0.34 micromol/L) was found in 11% of both sexes. Movement time, digit symbol, and block design (adjusted for age, sex, smoking, and creatinine) correlated independently with plasma tHcy (P < 0.01, < 0.05, and < 0.01, respectively); the simultaneity index and block design correlated with serum MMA (P < 0.05 for both). Vitamin therapy significantly decreased plasma tHcy (32%) and serum MMA (14%). No improvements were found in the movement or cognitive tests compared with placebo. Neither vitamin therapy nor changes in plasma tHcy, serum MMA, serum vitamin B-12, plasma folate, or whole-blood folate correlated with changes in movement or cognitive performance.

CONCLUSIONS

High plasma tHcy and serum MMA were prevalent and correlated inversely with movement and cognitive performance. Oral B vitamin treatment normalized plasma tHcy and serum MMA concentrations but did not affect movement or cognitive performance. This might have been due to irreversible or vitamin-independent neurocognitive decline or to an insufficient dose or duration of vitamins.

Authors+Show Affiliations

Department of Medicine at the Sahlgrenska Academy, Göteborg University, Göteborg, Sweden. catharina.lewerin@vgregion.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15883442

Citation

Lewerin, Catharina, et al. "Significant Correlations of Plasma Homocysteine and Serum Methylmalonic Acid With Movement and Cognitive Performance in Elderly Subjects but No Improvement From Short-term Vitamin Therapy: a Placebo-controlled Randomized Study." The American Journal of Clinical Nutrition, vol. 81, no. 5, 2005, pp. 1155-62.
Lewerin C, Matousek M, Steen G, et al. Significant correlations of plasma homocysteine and serum methylmalonic acid with movement and cognitive performance in elderly subjects but no improvement from short-term vitamin therapy: a placebo-controlled randomized study. Am J Clin Nutr. 2005;81(5):1155-62.
Lewerin, C., Matousek, M., Steen, G., Johansson, B., Steen, B., & Nilsson-Ehle, H. (2005). Significant correlations of plasma homocysteine and serum methylmalonic acid with movement and cognitive performance in elderly subjects but no improvement from short-term vitamin therapy: a placebo-controlled randomized study. The American Journal of Clinical Nutrition, 81(5), pp. 1155-62.
Lewerin C, et al. Significant Correlations of Plasma Homocysteine and Serum Methylmalonic Acid With Movement and Cognitive Performance in Elderly Subjects but No Improvement From Short-term Vitamin Therapy: a Placebo-controlled Randomized Study. Am J Clin Nutr. 2005;81(5):1155-62. PubMed PMID: 15883442.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Significant correlations of plasma homocysteine and serum methylmalonic acid with movement and cognitive performance in elderly subjects but no improvement from short-term vitamin therapy: a placebo-controlled randomized study. AU - Lewerin,Catharina, AU - Matousek,Michael, AU - Steen,Gunilla, AU - Johansson,Boo, AU - Steen,Bertil, AU - Nilsson-Ehle,Herman, PY - 2005/5/11/pubmed PY - 2005/6/29/medline PY - 2005/5/11/entrez SP - 1155 EP - 62 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 81 IS - 5 N2 - BACKGROUND: Deficiencies of vitamin B-12, folic acid, and vitamin B-6-as defined by laboratory measures-occur in 10-20% of elderly subjects. The clinical significance remains unresolved. OBJECTIVE: The objective was to explore any association between vitamin status and vitamin treatment and movement and cognitive performance in elderly subjects. DESIGN: Community-dwelling subjects (n = 209) with a median age of 76 y were randomly assigned to daily oral treatment with 0.5 mg cyanocobalamin, 0.8 mg folic acid, and 3 mg vitamin B-6 or placebo (double blind) for 4 mo. Movement and cognitive performance tests were performed before and after treatment. RESULTS: A high plasma total homocysteine (tHcy) concentration (> or =16 micromol/L) was found in 64% of men and in 45% of women, and a high serum methylmalonic acid (MMA) concentration (> or =0.34 micromol/L) was found in 11% of both sexes. Movement time, digit symbol, and block design (adjusted for age, sex, smoking, and creatinine) correlated independently with plasma tHcy (P < 0.01, < 0.05, and < 0.01, respectively); the simultaneity index and block design correlated with serum MMA (P < 0.05 for both). Vitamin therapy significantly decreased plasma tHcy (32%) and serum MMA (14%). No improvements were found in the movement or cognitive tests compared with placebo. Neither vitamin therapy nor changes in plasma tHcy, serum MMA, serum vitamin B-12, plasma folate, or whole-blood folate correlated with changes in movement or cognitive performance. CONCLUSIONS: High plasma tHcy and serum MMA were prevalent and correlated inversely with movement and cognitive performance. Oral B vitamin treatment normalized plasma tHcy and serum MMA concentrations but did not affect movement or cognitive performance. This might have been due to irreversible or vitamin-independent neurocognitive decline or to an insufficient dose or duration of vitamins. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/15883442/Significant_correlations_of_plasma_homocysteine_and_serum_methylmalonic_acid_with_movement_and_cognitive_performance_in_elderly_subjects_but_no_improvement_from_short_term_vitamin_therapy:_a_placebo_controlled_randomized_study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/81.5.1155 DB - PRIME DP - Unbound Medicine ER -