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Homocysteine as a Dementia Treatment

01/13/2005

Question:

I recently attended a caregiver meeting where homocysteine was brought up as a modifiable risk factor and treatment option for mild dementia and vascular dementia. Will this help?

Answer:

Your question addresses one of the newest areas of study in developing treatments for dementia.  However, this line of research, though promising, remains in the investigation phase, is preliminary at this point, and is not yet a standard treatment or prevention option.

Research has shown that blood levels of an amino acid called homocysteine are elevated in Alzheimer's disease (AD).   Elevated levels of homocysteine may contribute to the disease by vascular and direct neurotoxic mechanisms, where the brain and blood vessels in the brain are damaged by these elevated levels.  Homocysteine levels can be reduced by the administration of high dose supplements of folate and vitamins B6 and B12. Studies, or clinical trials, are currently in progress to determine if the reduction of homocysteine levels in persons with AD by using high doses of  folate/B6/B12 will slow the rate of cognitive decline.   At this point we cannot say that this is a treatment or a way of preventing dementia, but that is the ultimate hopes of this line of research.  Therefore, we cannot recommend that healthy individuals, or individuals with AD start taking these high dose supplements.  First, controlled clinical trials need to demonstrate effectiveness and safety.

However, many recent findings in the study of dementias like AD do point to the potential value of a healthy lifestyle with attention to a healthy, balanced diet and exercise.

If you are interested in participating in a clinical trial on reducing homocystine levels in persons with AD, please visit the ADEAR website listed below and click on the Clinical trials section for details regarding sites throughout the nation.

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Response by:

Paula K Ogrocki, PhD Paula K Ogrocki, PhD
Assistant Professor of Neurology
School of Medicine
Case Western Reserve University