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Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5)

Background: Elevated plasma homocysteine is a risk factor for Alzheimer disease, but the relevance of homocysteine lowering to slow the rate of cognitive aging is uncertain. Objective: The aim was to assess the effects of treatment with B vitamins compared with placebo, when administered for several...

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Autores principales: Clarke, Robert, Bennett, Derrick, Parish, Sarah, Lewington, Sarah, Skeaff, Murray, Eussen, Simone JPM, Lewerin, Catharina, Stott, David J, Armitage, Jane, Hankey, Graeme J, Lonn, Eva, Spence, J David, Galan, Pilar, de Groot, Lisette C, Halsey, Jim, Dangour, Alan D, Collins, Rory, Grodstein, Francine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Nutrition 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095663/
https://www.ncbi.nlm.nih.gov/pubmed/24965307
http://dx.doi.org/10.3945/ajcn.113.076349
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author Clarke, Robert
Bennett, Derrick
Parish, Sarah
Lewington, Sarah
Skeaff, Murray
Eussen, Simone JPM
Lewerin, Catharina
Stott, David J
Armitage, Jane
Hankey, Graeme J
Lonn, Eva
Spence, J David
Galan, Pilar
de Groot, Lisette C
Halsey, Jim
Dangour, Alan D
Collins, Rory
Grodstein, Francine
author_facet Clarke, Robert
Bennett, Derrick
Parish, Sarah
Lewington, Sarah
Skeaff, Murray
Eussen, Simone JPM
Lewerin, Catharina
Stott, David J
Armitage, Jane
Hankey, Graeme J
Lonn, Eva
Spence, J David
Galan, Pilar
de Groot, Lisette C
Halsey, Jim
Dangour, Alan D
Collins, Rory
Grodstein, Francine
author_sort Clarke, Robert
collection PubMed
description Background: Elevated plasma homocysteine is a risk factor for Alzheimer disease, but the relevance of homocysteine lowering to slow the rate of cognitive aging is uncertain. Objective: The aim was to assess the effects of treatment with B vitamins compared with placebo, when administered for several years, on composite domains of cognitive function, global cognitive function, and cognitive aging. Design: A meta-analysis was conducted by using data combined from 11 large trials in 22,000 participants. Domain-based z scores (for memory, speed, and executive function and a domain-composite score for global cognitive function) were available before and after treatment (mean duration: 2.3 y) in the 4 cognitive-domain trials (1340 individuals); Mini-Mental State Examination (MMSE)–type tests were available at the end of treatment (mean duration: 5 y) in the 7 global cognition trials (20,431 individuals). Results: The domain-composite and MMSE-type global cognitive function z scores both decreased with age (mean ± SE: −0.054 ± 0.004 and −0.036 ± 0.001/y, respectively). Allocation to B vitamins lowered homocysteine concentrations by 28% in the cognitive-domain trials but had no significant effects on the z score differences from baseline for individual domains or for global cognitive function (z score difference: 0.00; 95% CI: −0.05, 0.06). Likewise, allocation to B vitamins lowered homocysteine by 26% in the global cognition trials but also had no significant effect on end-treatment MMSE-type global cognitive function (z score difference: −0.01; 95% CI: −0.03, 0.02). Overall, the effect of a 25% reduction in homocysteine equated to 0.02 y (95% CI: −0.10, 0.13 y) of cognitive aging per year and excluded reductions of >1 mo per year of treatment. Conclusion: Homocysteine lowering by using B vitamins had no significant effect on individual cognitive domains or global cognitive function or on cognitive aging.
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spelling pubmed-40956632014-08-26 Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5) Clarke, Robert Bennett, Derrick Parish, Sarah Lewington, Sarah Skeaff, Murray Eussen, Simone JPM Lewerin, Catharina Stott, David J Armitage, Jane Hankey, Graeme J Lonn, Eva Spence, J David Galan, Pilar de Groot, Lisette C Halsey, Jim Dangour, Alan D Collins, Rory Grodstein, Francine Am J Clin Nutr Nutritional Epidemiology and Public Health Background: Elevated plasma homocysteine is a risk factor for Alzheimer disease, but the relevance of homocysteine lowering to slow the rate of cognitive aging is uncertain. Objective: The aim was to assess the effects of treatment with B vitamins compared with placebo, when administered for several years, on composite domains of cognitive function, global cognitive function, and cognitive aging. Design: A meta-analysis was conducted by using data combined from 11 large trials in 22,000 participants. Domain-based z scores (for memory, speed, and executive function and a domain-composite score for global cognitive function) were available before and after treatment (mean duration: 2.3 y) in the 4 cognitive-domain trials (1340 individuals); Mini-Mental State Examination (MMSE)–type tests were available at the end of treatment (mean duration: 5 y) in the 7 global cognition trials (20,431 individuals). Results: The domain-composite and MMSE-type global cognitive function z scores both decreased with age (mean ± SE: −0.054 ± 0.004 and −0.036 ± 0.001/y, respectively). Allocation to B vitamins lowered homocysteine concentrations by 28% in the cognitive-domain trials but had no significant effects on the z score differences from baseline for individual domains or for global cognitive function (z score difference: 0.00; 95% CI: −0.05, 0.06). Likewise, allocation to B vitamins lowered homocysteine by 26% in the global cognition trials but also had no significant effect on end-treatment MMSE-type global cognitive function (z score difference: −0.01; 95% CI: −0.03, 0.02). Overall, the effect of a 25% reduction in homocysteine equated to 0.02 y (95% CI: −0.10, 0.13 y) of cognitive aging per year and excluded reductions of >1 mo per year of treatment. Conclusion: Homocysteine lowering by using B vitamins had no significant effect on individual cognitive domains or global cognitive function or on cognitive aging. American Society for Nutrition 2014-08 2014-06-25 /pmc/articles/PMC4095663/ /pubmed/24965307 http://dx.doi.org/10.3945/ajcn.113.076349 Text en http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the CC-BY license (http://creativecommons.org/licenses/by/3.0/).
spellingShingle Nutritional Epidemiology and Public Health
Clarke, Robert
Bennett, Derrick
Parish, Sarah
Lewington, Sarah
Skeaff, Murray
Eussen, Simone JPM
Lewerin, Catharina
Stott, David J
Armitage, Jane
Hankey, Graeme J
Lonn, Eva
Spence, J David
Galan, Pilar
de Groot, Lisette C
Halsey, Jim
Dangour, Alan D
Collins, Rory
Grodstein, Francine
Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5)
title Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5)
title_full Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5)
title_fullStr Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5)
title_full_unstemmed Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5)
title_short Effects of homocysteine lowering with B vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5)
title_sort effects of homocysteine lowering with b vitamins on cognitive aging: meta-analysis of 11 trials with cognitive data on 22,000 individuals(1)(2)(3)(4)(5)
topic Nutritional Epidemiology and Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095663/
https://www.ncbi.nlm.nih.gov/pubmed/24965307
http://dx.doi.org/10.3945/ajcn.113.076349
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