~ Moderate Homocysteine Elevation Increases Stroke, Alzheimer's and Vascular Dementia Risk

In a study published in the October 3 2002 issue of Stroke: Journal of the American Heart Association (http://stroke.ahajournals.org/), researchers from Queen's University in Belfast, Ireland have found that having moderately high homocysteine is associated with three times the risk of Alzheimer's disease, and five times the risk of stroke and vascular dementia compared to those with healthier levels of the toxic amino acid.

The researchers studied 83 patients with Alzheimer's disease, 78 with vascular dementia, 64 stroke patients and 71 healthy volunteers, all in their seventies. Data was collected on diet, cholesterol, smoking history and blood pressure, and fasting plasma homocysteine levels were taken. The subjects were also tested for variation in the gene methylenetetrahydrofolate, which can affect folate metabolism. The B vitamin folate has been shown to reduce homocysteine.

An increase in plasma homocysteine was found in the Alzheimer's, vascular dementia and stroke groups compared with the healthy controls, which remained significant after adjustment for other factors. The findings were not related to mutations in the methylenetetrahydrofolate gene. Lead author and lecturer in geriatric medicine at Queen's University in Belfast, Stephen P. McIlroy, PhD, stated, ?Since B vitamins and foods fortified with folate can reduce homocysteine levels, this study suggests that B vitamin supplementation may be appropriate for most adults. It warrants a large placebo-controlled study of folate, and vitamins B6 and B12 in people at risk from dementia and stroke."

In an accompanying editorial, Amos D. Korczyn, MD, of Tel-Aviv University Medical School in Ramat-Aviv, Israel, advised that since dietary habits are so different among people, it may be appropriate to recommend 2 to 5 mg folic acid and a similar dose of vitamin B12 daily. This recommendation is based on the known safety of both vitamins, which do not have side effects even if used in excessive amounts, and their low cost."


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