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Moderately high homocysteine tied to stroke, Alzheimers risk

sely affect folate metabolism.

After correcting for other risk factors, elevated homocysteine was associated with a 2.9 times greater risk for Alzheimer's disease than risk in volunteers with lower levels of homocysteine. The stroke risk was 5.5 times greater, and for vascular dementia, it was 4.9 times greater. These findings were not related to having the MTHFR mutated gene.

In an accompanying editorial, Amos D. Korczyn, M.D., of the department of neurology at Tel-Aviv University Medical School in Ramat-Aviv, Israel, notes that there is no ultimate proof that homocysteine causes stroke or dementia. He says that elevated homocysteine could theoretically be the result of stroke or dementia. Additionally, he notes that poor diet which is common in old age, particularly among people with dementia may raise homocysteine.

However, Korcyzn also says it may now be appropriate to recommend that elderly people and particularly those with higher risk of vascular disease or dementia take vitamins B12 and folate.

"Since dietary habits are so different among people, it may be appropriate to recommend 2 to 5 mg folic acid and a similar dose of vitamin B12 daily," he says. "This recommendation is based on the known safety of both vitamins, which do not have side effects even if used in excessive amounts, and their low cost." McIlroy notes that in the United States many foods, especially cereals, are fortified with folate but this is not the case in the United Kingdom. Even with the fortified foods, a daily vitamin B supplement may be warranted especially after a stroke, he says.

The American Heart Association recommends that healthy people obtain adequate nutrient intakes from foods eaten in variety and moderation, rather than from supplements.


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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
3-Oct-2002


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