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A randomized placebo controlled trial of homocysteine lowering to reduce cognitive decline in older demented people


Kwok, T., Lee, J., Law, C. B., Pan, P. C., Yung, C. Y., Choi, K. C., Lam, L. C.


Clinical Nutrition (Edinburgh, Scotland), Volume: 30, No.: 3, Pages.: 297-302

Year of Publication



Introduction: Whether homocysteine lowering by B vitamins can reduce cognitive decline in Alzheimer disease and vascular dementia patients is unclear.; Methods and Materials: 140 subjects with mild to moderate Alzheimer disease or vascular dementia were randomly assigned to take 1 mg of methylcobalamin and 5 mg of folic acid, or placebo once daily for 24 months. The primary outcome was Mattis dementia rating scale (MDRS). Secondary outcomes were MDRS domain scores, neuropsychiatric inventory and Cornell scale for depression in dementia. Measurements were performed at baseline and every six months during the study. Fasting plasma tHCY concentrations were measured at baseline and month 18.; Results: Trial groups were well matched in baseline characteristics. The average plasma tHCY concentration of subjects was 14.1 ± 3.8 μmol/L. 80% of subjects completed the trial. The supplement group had average plasma tHCY reduced to 9.3 ± 2.7 μmol/L. There was no significant group difference in changes in any of the neuropsychological scores, but among those with elevated plasma tHCY (>13 μmol/L), the decline in MDRS (construction domain) was significantly smaller in the supplement group (median 0 versus 2 points in placebo group, P = 0.003).; Conclusion: Homocysteine lowering in dementia patients did not significantly reduce global cognitive decline.; Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Bibtex Citation

@article{Kwok_2011, doi = {10.1016/j.clnu.2010.12.004}, url = {}, year = 2011, month = {jun}, publisher = {Elsevier {BV}}, volume = {30}, number = {3}, pages = {297--302}, author = {T. Kwok and J. Lee and C.B. Law and P.C. Pan and C.Y. Yung and K.C. Choi and L.C. Lam}, title = {A randomized placebo controlled trial of homocysteine lowering to reduce cognitive decline in older demented people}, journal = {Clinical Nutrition} }


acid, aged, aged, 80 and over, alzheimer disease, analogs derivatives, and, blood, cognition disorders, dementia vascular, depression, double-blind method, drug therapy, drug therapy combination, etiology, female, folic, folic acid, homocysteine, hong kong, humans, hyperhomocysteinemia, male, methylcobalamin, neuropsychological tests, patient dropouts, physiopathology, plasma, prevention & control, thcy, therapeutic use, vitamin b 12, vitamin b complex

Countries of Study

Hong Kong

Types of Dementia

Alzheimer’s Disease, Vascular Dementia

Types of Study

Randomised Controlled Trial

Type of Outcomes

Behaviour, Cognition, Depression and Anxiety, Other

Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Herbal remedies, vitamins, dietary supplements