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A Pilot Study of Vitamins to Lower Plasma Homocysteine Levels in Alzheimer Disease

Received November 18, 2002; revised December 23, 2002, January 3, 2003; accepted January 3, 2003. From the Department of Neurology, Georgetown University Medical Center, Washington, DC. Address correspondence to Paul S. Aisen, M.D., Department of Neurology, Georgetown University Medical Center, Building D, Suite 207, 4000 Reservoir Road NW, Washington, DC 20007.

OBJECTIVE: Authors determined the impact of high-dose vitamin supplements on plasma homocysteine levels in patients with Alzheimer disease (AD). METHODS: Authors used an open-label trial of folic acid, vitamin B₁₂, and vitamin B₆, in combination for 8 weeks, with measurement of plasma homocysteine levels in the fasting state and after methionine-loading. A total of 69 subjects with AD were enrolled, including 33 who were taking standard multivitamin supplements; 66 were available at 8-week follow-up. RESULTS: The high-dose vitamin regimen was associated with a significant reduction in fasting and post–methionine-loading homocysteine. Reductions were greater in the subgroup not using multivitamins, but were also significant in the multivitamin users. CONCLUSION: High-dose vitamin supplementation reduces homocysteine levels in patients with AD. The effect of supplementation on rate of cognitive decline will be assessed later in a randomized, double-blind study.

Key Words: Alzheimer Disease • Vitamin Supplements • Homocysteine

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