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A controlled trial of homocysteine lowering and cognitive performance.
N Engl J Med 2006; 354(26):2764-72NEJM

Abstract

BACKGROUND

The results of observational studies suggest that plasma homocysteine concentrations are inversely related to cognitive function in older people. Our objective was to test the hypothesis that lowering the plasma homocysteine concentration improves cognitive function in healthy older people.

METHODS

We conducted a two-year, double-blind, placebo-controlled, randomized clinical trial involving 276 healthy participants, 65 years of age or older, with plasma homocysteine concentrations of at least 13 micromol per liter. Homocysteine-lowering treatment was a daily supplement containing folate (1000 microg) and vitamins B12 (500 microg) and B6 (10 mg). Tests of cognition were conducted at baseline and after one and two years of treatment. Treatment effects were adjusted for baseline values, sex, and education.

RESULTS

On average, during the course of the study, the plasma homocysteine concentration was 4.36 micromol per liter (95 percent confidence interval, 3.81 to 4.91 micromol per liter) lower in the vitamin group than in the placebo group (P<0.001). Overall, there were no significant differences between the vitamin and placebo groups in the scores on tests of cognition.

CONCLUSIONS

The results of this trial do not support the hypothesis that homocysteine lowering with B vitamins improves cognitive performance. (Australian Clinical Trials registry number, ACTR NO 12605000030673.).

Authors+Show Affiliations

Departments of Human Nutrition, University of Otago, Dunedin, New Zealand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16807413

Citation

McMahon, Jennifer A., et al. "A Controlled Trial of Homocysteine Lowering and Cognitive Performance." The New England Journal of Medicine, vol. 354, no. 26, 2006, pp. 2764-72.
McMahon JA, Green TJ, Skeaff CM, et al. A controlled trial of homocysteine lowering and cognitive performance. N Engl J Med. 2006;354(26):2764-72.
McMahon, J. A., Green, T. J., Skeaff, C. M., Knight, R. G., Mann, J. I., & Williams, S. M. (2006). A controlled trial of homocysteine lowering and cognitive performance. The New England Journal of Medicine, 354(26), pp. 2764-72.
McMahon JA, et al. A Controlled Trial of Homocysteine Lowering and Cognitive Performance. N Engl J Med. 2006 Jun 29;354(26):2764-72. PubMed PMID: 16807413.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A controlled trial of homocysteine lowering and cognitive performance. AU - McMahon,Jennifer A, AU - Green,Timothy J, AU - Skeaff,C Murray, AU - Knight,Robert G, AU - Mann,Jim I, AU - Williams,Sheila M, PY - 2006/6/30/pubmed PY - 2006/7/11/medline PY - 2006/6/30/entrez SP - 2764 EP - 72 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 354 IS - 26 N2 - BACKGROUND: The results of observational studies suggest that plasma homocysteine concentrations are inversely related to cognitive function in older people. Our objective was to test the hypothesis that lowering the plasma homocysteine concentration improves cognitive function in healthy older people. METHODS: We conducted a two-year, double-blind, placebo-controlled, randomized clinical trial involving 276 healthy participants, 65 years of age or older, with plasma homocysteine concentrations of at least 13 micromol per liter. Homocysteine-lowering treatment was a daily supplement containing folate (1000 microg) and vitamins B12 (500 microg) and B6 (10 mg). Tests of cognition were conducted at baseline and after one and two years of treatment. Treatment effects were adjusted for baseline values, sex, and education. RESULTS: On average, during the course of the study, the plasma homocysteine concentration was 4.36 micromol per liter (95 percent confidence interval, 3.81 to 4.91 micromol per liter) lower in the vitamin group than in the placebo group (P<0.001). Overall, there were no significant differences between the vitamin and placebo groups in the scores on tests of cognition. CONCLUSIONS: The results of this trial do not support the hypothesis that homocysteine lowering with B vitamins improves cognitive performance. (Australian Clinical Trials registry number, ACTR NO 12605000030673.). SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/16807413/A_controlled_trial_of_homocysteine_lowering_and_cognitive_performance_ L2 - http://www.nejm.org/doi/full/10.1056/NEJMoa054025?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -