Randomized controlled trial of homocysteine-lowering vitamin treatment in elderly patients with vascular disease
BACKGROUND: Homocysteine is an independent risk factor for vascular disease and is associated with dementia in older people. Potential mechanisms include altered endothelial and hemostatic function. OBJECTIVE: We aimed to determine the effects of folic acid plus vitamin B-12, riboflavin, and vitamin...
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Published in | The American journal of clinical nutrition Vol. 82; no. 6; pp. 1320 - 1326 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Bethesda, MD
American Society for Clinical Nutrition
01.12.2005
American Society for Clinical Nutrition, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | BACKGROUND: Homocysteine is an independent risk factor for vascular disease and is associated with dementia in older people. Potential mechanisms include altered endothelial and hemostatic function. OBJECTIVE: We aimed to determine the effects of folic acid plus vitamin B-12, riboflavin, and vitamin B-6 on homocysteine and cognitive function. DESIGN: This was a factorial 2 x 2 x 2, randomized, placebo-controlled, double-blind study with 3 active treatments: folic acid (2.5 mg) plus vitamin B-12 (500 [micro]g), vitamin B-6 (25 mg), and riboflavin (25 mg). We studied 185 patients aged [>/=]65 y with ischemic vascular disease. Outcome measures included plasma homocysteine, fibrinogen, and von Willebrand factor at 3 mo and cognitive change (determined with the use of the Letter Digit Coding Test and on the basis of the Telephone Interview of Cognitive Status) after 1 y. RESULTS: The mean (±SD) baseline plasma homocysteine concentration was 16.5 ± 6.4 [micro]mol/L. This value was 5.0 (95% CI: 3.8, 6.2) [micro]mol/L lower in patients given folic acid plus vitamin B-12 than in patients not given folic acid plus vitamin B-12 but did not change significantly with vitamin B-6 or riboflavin treatment. Homocysteine lowering with folic acid plus vitamin B-12 had no significant effect, relative to the 2 other treatments, on fibrinogen, von Willebrand factor, or cognitive performance as measured by the Letter Digit Coding Test (mean change: -1; 95% CI: -2.3, 1.4) and the Telephone Interview of Cognitive Status (-0.7; 95% CI: -1.7, 0.4). CONCLUSION: Oral folic acid plus vitamin B-12 decreased homocysteine concentrations in elderly patients with vascular disease but was not associated with statistically significant beneficial effects on cognitive function over the short or medium term. |
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Bibliography: | http://www.ajcn.org/contents-by-date.0.shtml |
ISSN: | 0002-9165 1938-3207 |
DOI: | 10.1093/ajcn/82.6.1320 |