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Randomized controlled trial of homocysteine-lowering vitamin treatment in elderly patients with vascular disease

David J Stott1, Graham MacIntosh, Gordon D O Lowe

  • 1Division of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom. d.j.stott@clinmed.gla.ac.uk

The American Journal of Clinical Nutrition
|December 8, 2005
PubMed

Insights

Folic acid and vitamin B-12 supplementation effectively lowered homocysteine levels in older adults with vascular disease. However, this intervention did not show significant improvements in cognitive function over one year.

Area of Science:

  • Neurology
  • Cardiology
  • Nutritional Science

Background:

  • Elevated homocysteine is a risk factor for vascular disease and dementia in the elderly.
  • Potential mechanisms involve endothelial and hemostatic dysfunction.

Purpose of the Study:

  • To investigate the impact of folic acid plus vitamin B-12, riboflavin, and vitamin B-6 on homocysteine levels.
  • To assess the effects of these supplements on cognitive function in older adults with vascular disease.

Main Methods:

  • A randomized, double-blind, placebo-controlled factorial study.
  • 185 patients aged 65+ with ischemic vascular disease received folic acid (2.5 mg) + B-12 (500 µg), B-6 (25 mg), or riboflavin (25 mg).
  • Outcomes included plasma homocysteine, fibrinogen, von Willebrand factor, and cognitive tests at 3 months and 1 year.

Main Results:

  • Folic acid plus vitamin B-12 significantly reduced plasma homocysteine by 5.0 µmol/L.
  • Vitamin B-6 and riboflavin did not significantly affect homocysteine levels.
  • No significant improvements in cognitive function (Letter Digit Coding Test, Telephone Interview of Cognitive Status) were observed with any treatment.

Conclusions:

  • Oral folic acid plus vitamin B-12 effectively lowers homocysteine in elderly patients with vascular disease.
  • This supplementation did not demonstrate statistically significant benefits for cognitive function in the short to medium term.
Abstract

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