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A randomized placebo controlled trial of homocysteine lowering to reduce cognitive decline in older demented people.
Clin Nutr 2011; 30(3):297-302CN

Abstract

INTRODUCTION

Whether homocysteine lowering by B vitamins can reduce cognitive decline in Alzheimer disease and vascular dementia patients is unclear.

METHODS AND MATERIALS

140 subjects with mild to moderate Alzheimer disease or vascular dementia were randomly assigned to take 1 mg of methylcobalamin and 5 mg of folic acid, or placebo once daily for 24 months. The primary outcome was Mattis dementia rating scale (MDRS). Secondary outcomes were MDRS domain scores, neuropsychiatric inventory and Cornell scale for depression in dementia. Measurements were performed at baseline and every six months during the study. Fasting plasma tHCY concentrations were measured at baseline and month 18.

RESULTS

Trial groups were well matched in baseline characteristics. The average plasma tHCY concentration of subjects was 14.1 ± 3.8 μmol/L. 80% of subjects completed the trial. The supplement group had average plasma tHCY reduced to 9.3 ± 2.7 μmol/L. There was no significant group difference in changes in any of the neuropsychological scores, but among those with elevated plasma tHCY (>13 μmol/L), the decline in MDRS (construction domain) was significantly smaller in the supplement group (median 0 versus 2 points in placebo group, P = 0.003).

CONCLUSION

Homocysteine lowering in dementia patients did not significantly reduce global cognitive decline.

Authors+Show Affiliations

Department of Medicine and Therapeutics, Prince of Wales Hospital and Shatin Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong. tkwok@cuhk.edu.hkNo affiliation info availableNo 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

21216507

Citation

Kwok, T, et al. "A Randomized Placebo Controlled Trial of Homocysteine Lowering to Reduce Cognitive Decline in Older Demented People." Clinical Nutrition (Edinburgh, Scotland), vol. 30, no. 3, 2011, pp. 297-302.
Kwok T, Lee J, Law CB, et al. A randomized placebo controlled trial of homocysteine lowering to reduce cognitive decline in older demented people. Clin Nutr. 2011;30(3):297-302.
Kwok, T., Lee, J., Law, C. B., Pan, P. C., Yung, C. Y., Choi, K. C., & Lam, L. C. (2011). A randomized placebo controlled trial of homocysteine lowering to reduce cognitive decline in older demented people. Clinical Nutrition (Edinburgh, Scotland), 30(3), pp. 297-302. doi:10.1016/j.clnu.2010.12.004.
Kwok T, et al. A Randomized Placebo Controlled Trial of Homocysteine Lowering to Reduce Cognitive Decline in Older Demented People. Clin Nutr. 2011;30(3):297-302. PubMed PMID: 21216507.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized placebo controlled trial of homocysteine lowering to reduce cognitive decline in older demented people. AU - Kwok,T, AU - Lee,J, AU - Law,C B, AU - Pan,P C, AU - Yung,C Y, AU - Choi,K C, AU - Lam,L C, Y1 - 2011/01/08/ PY - 2010/04/30/received PY - 2010/11/15/revised PY - 2010/12/10/accepted PY - 2011/1/11/entrez PY - 2011/1/11/pubmed PY - 2011/10/4/medline SP - 297 EP - 302 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 30 IS - 3 N2 - INTRODUCTION: Whether homocysteine lowering by B vitamins can reduce cognitive decline in Alzheimer disease and vascular dementia patients is unclear. METHODS AND MATERIALS: 140 subjects with mild to moderate Alzheimer disease or vascular dementia were randomly assigned to take 1 mg of methylcobalamin and 5 mg of folic acid, or placebo once daily for 24 months. The primary outcome was Mattis dementia rating scale (MDRS). Secondary outcomes were MDRS domain scores, neuropsychiatric inventory and Cornell scale for depression in dementia. Measurements were performed at baseline and every six months during the study. Fasting plasma tHCY concentrations were measured at baseline and month 18. RESULTS: Trial groups were well matched in baseline characteristics. The average plasma tHCY concentration of subjects was 14.1 ± 3.8 μmol/L. 80% of subjects completed the trial. The supplement group had average plasma tHCY reduced to 9.3 ± 2.7 μmol/L. There was no significant group difference in changes in any of the neuropsychological scores, but among those with elevated plasma tHCY (>13 μmol/L), the decline in MDRS (construction domain) was significantly smaller in the supplement group (median 0 versus 2 points in placebo group, P = 0.003). CONCLUSION: Homocysteine lowering in dementia patients did not significantly reduce global cognitive decline. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/21216507/A_randomized_placebo_controlled_trial_of_homocysteine_lowering_to_reduce_cognitive_decline_in_older_demented_people_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(10)00216-5 DB - PRIME DP - Unbound Medicine ER -