2010
    High Quality

    Homocysteine and Cognitive Function: B Vitamin Supplementation Trial

    Smith AD, Smith SM, de Jager CA, Whitbread P, Johnston C, Agacinski G, Oulhaj A, Bradley KM, Jacoby R, Refsum H

    Published in PLoS One

    Abstract

    Randomized controlled trial showing that B vitamin supplementation slows cognitive decline in elderly individuals with mild cognitive impairment.

    Methodology

    Randomised, double-blind, placebo-controlled trial (VITACOG) with serial MRI to measure whole-brain atrophy rate over 24 months.

    Key Findings

    In 168 older adults with mild cognitive impairment, high-dose B vitamins (folic acid 0.8 mg, B12 0.5 mg, B6 20 mg) lowered homocysteine by roughly 30% and slowed the rate of brain atrophy by about 30% over two years (0.76%/yr vs 1.08%/yr). Benefit was greatest in those with the highest baseline homocysteine.

    Conclusions

    Homocysteine-lowering B vitamins slow accelerated brain atrophy in people with mild cognitive impairment and elevated homocysteine, supporting homocysteine as a modifiable risk factor rather than a bystander.

    Limitations

    Single-centre trial, surrogate imaging endpoint rather than dementia incidence, benefit restricted to participants with raised homocysteine, and results have not been replicated in larger trials.

    Supplements Studied

    The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins.

    The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins.

    Outcomes Measured

    The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins.

    The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins.

    Related Health Concerns

    Study Details

    Year:2010
    Sample Size:168
    Duration:104 weeks
    Quality Score:8/10

    Disclosures

    Funding

    Charitable and academic funding (Charles Wolfson Charitable Trust, Medical Research Council and others); vitamins supplied by Meda AB

    This information is for educational purposes only. Always consult a healthcare professional before starting any supplement regimen.