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Homocysteine as a biomarker for cognitive dysfunction in the elderly

Schulz, Ralf-Joachim

Current Opinion in Clinical Nutrition and Metabolic Care: November 2007 - Volume 10 - Issue 6 - p 718–723
doi: 10.1097/MCO.0b013e3282f0cfe3
Micronutrients: Edited by Hans Biesalski and Henry Lukaski

Purpose of review Homocysteine and B vitamins have been investigated in association with cognitive dysfunction in healthy and in multimorbid elderly patients. Whether reduction of hyperhomocystemia is reducing the risk of dementia or Alzheimer's disease is still under investigation.

Recent findings High homocysteine concentrations are associated with poorer cognitive function but can be influenced by a number of factors. The results of epidemiological studies are inconsistent in showing an association between elevated homocysteine levels and dementia or Alzheimer disease. Although prospective studies show a trend towards a benefit of homocysteine-related B vitamin substitution, consistent data are expected from upcoming clinical intervention trials. Data from recent clinical randomized trials including various cognitive tests, different aging groups and supplements in different doses are not sufficient to allow recommendation of homocysteine-reducing therapy with folate or vitamin B12 substitution. According to the published data it remains to be proven whether a reduction in homocysteine will improve cognitive performance.

Summary Homocysteine by itself is not a useful marker for screening cognitive decline, or Alzheimer disease but works as a surrogate parameter for malnutrition and organ insufficiency in the cognitive-declining patient.

Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Research Group on Geriatrics at ‘Ev. Geriatriezentrum Berlin’, Berlin, Germany

Correspondence to Ralf-Joachim Schulz, PhD, MD, Charité – Universitätsmedizin Berlin, Campus Virchow-Klinikum, Research Group on Geriatrics at ‘Ev. Geriatriezentrum Berlin’, Reinickendorfer Straße 61, 13347 Berlin, Germany Tel: +49 30 4594 1944; fax: +49 30 4594 1113; e-mail: ralf-joachim.schulz@charite.de

© 2007 Lippincott Williams & Wilkins, Inc.