Abstract
Elevated plasma homocysteine (tHcy) concentrations have been associated with an increased risk of developing dementia and Alzheimer's disease (AD). It is not clear, however, if an elevation in tHcy concentration is a 'risk factor' with a direct pathophysiological role in the development of the disease or merely a 'risk marker' reflecting an underlying process such as oxidative stress responsible for both the high tHcy concentrations and the development of AD. Epidemiological studies have confirmed that elevations in plasma tHcy temporally precede the development of dementia and that there is a continuous, inverse linear relation between plasma tHcy concentrations and cognitive performance in older persons. Several potential biological pathways that could mediate the observed association are briefly reviewed. In light of these data and the growing parallel interest in plasma tHcy as an emerging vascular risk factor there was considerable hope that vitamin therapy with folate, B12 and B6, shown to lower plasma tHcy levels, could significantly reduce the risk of stroke and dementia permitting healthy brain aging. The results from recent trials addressing the secondary prevention of stroke and myocardial infarction trials have been disappointing. However, the role of vitamins and other homocysteine lowering treatments in the primary prevention of stroke and dementia, as well as their role in preserving cognition among persons with mild cognitive impairment and early dementia deserves to be fully pursued.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 393-398 |
| Number of pages | 6 |
| Journal | Journal of Alzheimer's Disease |
| Volume | 9 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jan 1 2006 |
| Externally published | Yes |
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Keywords
- Alzheimer disease
- Dementia
- Homocysteine
- Plasma
- Risk factor
ASJC Scopus subject areas
- Neuroscience(all)
- Clinical Psychology
- Geriatrics and Gerontology
- Psychiatry and Mental health
Cite this
Elevated plasma homocysteine levels : Risk factor or risk marker for the development of dementia and Alzheimer's disease? / Seshadri, Sudha.
In: Journal of Alzheimer's Disease, Vol. 9, No. 4, 01.01.2006, p. 393-398.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Elevated plasma homocysteine levels
T2 - Risk factor or risk marker for the development of dementia and Alzheimer's disease?
AU - Seshadri, Sudha
PY - 2006/1/1
Y1 - 2006/1/1
N2 - Elevated plasma homocysteine (tHcy) concentrations have been associated with an increased risk of developing dementia and Alzheimer's disease (AD). It is not clear, however, if an elevation in tHcy concentration is a 'risk factor' with a direct pathophysiological role in the development of the disease or merely a 'risk marker' reflecting an underlying process such as oxidative stress responsible for both the high tHcy concentrations and the development of AD. Epidemiological studies have confirmed that elevations in plasma tHcy temporally precede the development of dementia and that there is a continuous, inverse linear relation between plasma tHcy concentrations and cognitive performance in older persons. Several potential biological pathways that could mediate the observed association are briefly reviewed. In light of these data and the growing parallel interest in plasma tHcy as an emerging vascular risk factor there was considerable hope that vitamin therapy with folate, B12 and B6, shown to lower plasma tHcy levels, could significantly reduce the risk of stroke and dementia permitting healthy brain aging. The results from recent trials addressing the secondary prevention of stroke and myocardial infarction trials have been disappointing. However, the role of vitamins and other homocysteine lowering treatments in the primary prevention of stroke and dementia, as well as their role in preserving cognition among persons with mild cognitive impairment and early dementia deserves to be fully pursued.
AB - Elevated plasma homocysteine (tHcy) concentrations have been associated with an increased risk of developing dementia and Alzheimer's disease (AD). It is not clear, however, if an elevation in tHcy concentration is a 'risk factor' with a direct pathophysiological role in the development of the disease or merely a 'risk marker' reflecting an underlying process such as oxidative stress responsible for both the high tHcy concentrations and the development of AD. Epidemiological studies have confirmed that elevations in plasma tHcy temporally precede the development of dementia and that there is a continuous, inverse linear relation between plasma tHcy concentrations and cognitive performance in older persons. Several potential biological pathways that could mediate the observed association are briefly reviewed. In light of these data and the growing parallel interest in plasma tHcy as an emerging vascular risk factor there was considerable hope that vitamin therapy with folate, B12 and B6, shown to lower plasma tHcy levels, could significantly reduce the risk of stroke and dementia permitting healthy brain aging. The results from recent trials addressing the secondary prevention of stroke and myocardial infarction trials have been disappointing. However, the role of vitamins and other homocysteine lowering treatments in the primary prevention of stroke and dementia, as well as their role in preserving cognition among persons with mild cognitive impairment and early dementia deserves to be fully pursued.
KW - Alzheimer disease
KW - Dementia
KW - Homocysteine
KW - Plasma
KW - Risk factor
UR - http://www.scopus.com/inward/record.url?scp=33747391975&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33747391975&partnerID=8YFLogxK
U2 - 10.3233/JAD-2006-9404
DO - 10.3233/JAD-2006-9404
M3 - Review article
C2 - 16917147
AN - SCOPUS:33747391975
VL - 9
SP - 393
EP - 398
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
SN - 1387-2877
IS - 4
ER -