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Homocysteine, vitamin B6, and vascular disease in AD patients

J W Miller1, R Green, D M Mungas

  • 1Department of Medical Pathology, University of California, Davis, School of Medicine, Sacramento 95817, USA. jwmiller@ucdavis.edu

Neurology
|May 30, 2002
PubMed

Insights

Elevated homocysteine in Alzheimer's disease (AD) is linked to vascular issues, not AD itself. Many AD patients show low vitamin B6 status, a finding needing further research into its role in AD progression.

Area of Science:

  • Neurology
  • Biochemistry
  • Gerontology

Background:

  • Cerebrovascular disease is a known cause of dementia.
  • Elevated plasma homocysteine levels are associated with dementia and Alzheimer's disease (AD).
  • Vitamin B6 status, a factor in homocysteine levels, has not been well-characterized in AD patients.

Purpose of the Study:

  • To investigate plasma homocysteine and vitamin B6 status in AD patients.
  • To determine the relationship between vitamin B6 status, homocysteine levels, and vascular disease in AD.
  • To assess the prevalence of vascular disease in AD patients.

Main Methods:

  • Studied 43 AD patients and 37 controls for homocysteine, B vitamin status (folate, B12, pyridoxal-5'-phosphate [PLP]), kidney, and thyroid function.
  • Assessed vascular disease presence using medical histories and brain imaging (CT, MRI).

Main Results:

  • Elevated plasma homocysteine was not significantly associated with AD but strongly linked to vascular disease (OR=10.0, p=0.03).
  • Low plasma PLP (<25 nmol/L) was prevalent in AD patients (OR=12.3, p=0.01).
  • No significant correlation found between vascular disease and PLP, or between plasma homocysteine and PLP.

Conclusions:

  • Elevated homocysteine in AD patients is likely due to co-existing vascular disease, not AD pathology.
  • Low vitamin B6 status is common in individuals with AD.
  • Further research is needed to clarify if homocysteine or vitamin B6 status directly impacts AD pathogenesis or progression.
Abstract

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