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B-vitamins and prevention of dementia.

Abstract

Elevated plasma homocysteine (Hcy) concentrations have been implicated with risk of cognitive impairment and dementia, but it is unclear whether low vitamin B12 or folate status is responsible for cognitive decline. Most studies reporting associations between cognitive function and Hcy or B-vitamins have used a cross-sectional or case-control design and have been unable to exclude the possibility that such associations are a result of the disease rather than being causal. The Hcy hypothesis of dementia has attracted considerable interest, as Hcy can be easily lowered by folic acid and vitamin B12, raising the prospect that B-vitamin supplementation could lower the risk of dementia. While some trials assessing effects on cognitive function have used folic acid alone, vitamin B12 alone or a combination, few trials have included a sufficient number of participants to provide reliable evidence. An individual-patient-data meta-analysis of all randomised trials of the effects on cognitive function and vascular risk of lowering Hcy with B-vitamins will maximise the power to assess the epidemiologically-predicted differences in risk. Among the twelve large randomised Hcy-lowering trials for prevention of vascular disease, data should be available on about 30 000 participants with cognitive function. The principal investigators of such trials have agreed to combine individual-participant data from their trials after their separate publication.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Clinical Trial Service Unit, Richard Doll Building, University of Oxford, Oxford OX3 7LF, UK.

    Source

    MeSH

    Aged
    Aged, 80 and over
    Cognition
    Dementia
    Folic Acid
    Folic Acid Deficiency
    Homocysteine
    Humans
    Risk Factors
    Vitamin B 12
    Vitamin B 12 Deficiency
    Vitamin B Complex

    Pub Type(s)

    Lecture

    Language

    eng

    PubMed ID

    18234134

    Citation

    Clarke, Robert. "B-vitamins and Prevention of Dementia." The Proceedings of the Nutrition Society, vol. 67, no. 1, 2008, pp. 75-81.
    Clarke R. B-vitamins and prevention of dementia. Proc Nutr Soc. 2008;67(1):75-81.
    Clarke, R. (2008). B-vitamins and prevention of dementia. The Proceedings of the Nutrition Society, 67(1), pp. 75-81. doi:10.1017/S0029665108006046.
    Clarke R. B-vitamins and Prevention of Dementia. Proc Nutr Soc. 2008;67(1):75-81. PubMed PMID: 18234134.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - B-vitamins and prevention of dementia. A1 - Clarke,Robert, PY - 2008/2/1/pubmed PY - 2008/8/20/medline PY - 2008/2/1/entrez SP - 75 EP - 81 JF - The Proceedings of the Nutrition Society JO - Proc Nutr Soc VL - 67 IS - 1 N2 - Elevated plasma homocysteine (Hcy) concentrations have been implicated with risk of cognitive impairment and dementia, but it is unclear whether low vitamin B12 or folate status is responsible for cognitive decline. Most studies reporting associations between cognitive function and Hcy or B-vitamins have used a cross-sectional or case-control design and have been unable to exclude the possibility that such associations are a result of the disease rather than being causal. The Hcy hypothesis of dementia has attracted considerable interest, as Hcy can be easily lowered by folic acid and vitamin B12, raising the prospect that B-vitamin supplementation could lower the risk of dementia. While some trials assessing effects on cognitive function have used folic acid alone, vitamin B12 alone or a combination, few trials have included a sufficient number of participants to provide reliable evidence. An individual-patient-data meta-analysis of all randomised trials of the effects on cognitive function and vascular risk of lowering Hcy with B-vitamins will maximise the power to assess the epidemiologically-predicted differences in risk. Among the twelve large randomised Hcy-lowering trials for prevention of vascular disease, data should be available on about 30 000 participants with cognitive function. The principal investigators of such trials have agreed to combine individual-participant data from their trials after their separate publication. SN - 0029-6651 UR - https://www.unboundmedicine.com/medline/citation/18234134/B_vitamins_and_prevention_of_dementia_ L2 - https://www.cambridge.org/core/product/identifier/S0029665108006046/type/journal_article DB - PRIME DP - Unbound Medicine ER -