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Journal ArticleDOI

Homocysteine, B Vitamins, and Cognitive Impairment

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TLDR
Trials in high-risk subjects, which have taken into account the baseline B vitamin status, show a slowing of cognitive decline and of atrophy in critical brain regions, results that are consistent with modification of the Alzheimer's disease process.
Abstract
Moderately elevated plasma total homocysteine (tHcy) is a strong modifiable risk factor for vascular dementia and Alzheimer's disease. Prospectively, elevated tHcy is associated with cognitive decline, white matter damage, brain atrophy, neurofibrillary tangles, and dementia. Most homocysteine-lowering trials with folate and vitamins B6 and/or B12 tested as protective agents against cognitive decline were poorly designed by including subjects unlikely to benefit during the trial period. In contrast, trials in high-risk subjects, which have taken into account the baseline B vitamin status, show a slowing of cognitive decline and of atrophy in critical brain regions, results that are consistent with modification of the Alzheimer's disease process. Homocysteine may interact with both risk factors and protective factors, thereby identifying people at risk but also providing potential strategies for early intervention. Public health steps to slow cognitive decline should be promoted in individuals who are at r...

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Citations
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Journal ArticleDOI

One-Carbon Metabolism in Health and Disease

TL;DR: The fundamentals of mammalian 1C metabolism, including the pathways active in different compartments, cell types, and biological states, are reviewed and new opportunities for selective therapeutic intervention are highlighted.
Journal ArticleDOI

Vitamin B12 deficiency from the perspective of a practicing hematologist

TL;DR: B12 deficiency is the leading cause of megaloblastic anemia, and although more common in the elderly, can occur at any age, and is best diagnosed using a combination of tests because none alone is completely reliable.
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Mediterranean diet: The role of long-chain ω-3 fatty acids in fish; polyphenols in fruits, vegetables, cereals, coffee, tea, cacao and wine; probiotics and vitamins in prevention of stroke, age-related cognitive decline, and Alzheimer disease.

TL;DR: The mechanisms of action of the dietary components of the Mediterranean diet are reviewed in prevention of cardiovascular disease, stroke, age-associated cognitive decline and Alzheimer disease, and the important dietary role of cereal grains in Prevention of coronary disease and stroke is reviewed.
Journal ArticleDOI

Homocysteine Modification in Protein Structure/Function and Human Disease.

TL;DR: Mechanisms by which hyperhomocysteinemia affects cellular proteostasis are described, a comprehensive account of the biological chemistry of homocysteine-containing proteins is provided, and pathophysiological consequences and clinical implications of their formation are discussed.
References
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Journal ArticleDOI

‘Mendelian randomization’: can genetic epidemiology contribute to understanding environmental determinants of disease?

TL;DR: Mendelian randomization provides new opportunities to test causality and demonstrates how investment in the human genome project may contribute to understanding and preventing the adverse effects on human health of modifiable exposures.
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Plasma Homocysteine as a Risk Factor for Dementia and Alzheimer's Disease

TL;DR: Dementia developed in 111 subjects, including 83 given a diagnosis of Alzheimer's disease, over a median follow-up period of eight years, and plasma levels of folate and vitamins B12 and B6 increased.
Journal ArticleDOI

Homocysteine and Cardiovascular Disease

TL;DR: In this article, an elevated level of total homocysteine (tHcy) in blood, denoted hyperhomocysteinemia, is emerging as a prevalent and strong risk factor for atherosclerotic vascular disease in the coronary, cerebral, and peripheral vessels, and for arterial and venous thromboembolism.
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The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis

TL;DR: White matter hyperintensities indicate an increased risk of cerebrovascular events when identified as part of diagnostic investigations, and support their use as an intermediate marker in a research setting.
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