Evidence map›Paper›PMID 29480200›Full record

ArticleJournal of Alzheimer's disease : JAD2018

Homocysteine and Dementia: An International Consensus Statement.

A David Smith, Helga Refsum, Teodoro Bottiglieri, Michael Fenech, Babak Hooshmand, Andrew McCaddon, Joshua W Miller, Irwin H Rosenberg, Rima Obeid

Open access · hybridAbstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of Alzheimer's disease : JAD, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 182 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
182citing papers in PubMed, 10 pooled it
29.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

182 citing papers in PubMed, 10 syntheses or guidelines pooled it, 349 citations in OpenAlex.

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  10. Aggressive Behaviors in Alzheimer Disease and Mild Cognitive Impairment: Systematic Review and Meta-Analysis.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2019
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122 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 9 institutions in 6 countries.

A David SmithOPTIMA, Department of Pharmacology, University of Oxford, Oxford, UK.
Helga RefsumDepartment of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway.
Teodoro BottiglieriCenter of Metabolomics, Institute of Metabolic Disease, Baylor Scott & White Research Institute, Dallas, TX, USA.
Michael FenechGenome Health and Personalised Nutrition Laboratory, CSIRO Health and Biosecurity, Adelaide BC, SA, Australia.
Babak HooshmandAging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
Andrew McCaddonCardiff University, School of Medicine, Gwenfro Units 6/7, Wrexham, UK.
Joshua W MillerDepartment of Nutritional Sciences, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
Irwin H RosenbergFriedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
Rima ObeidDepartment of Clinical Chemistry and Laboratory Medicine, University Hospital of the Saarland, Germany.
Baylor Medical Center at Garland · USCardiff University · GBCSIRO Health and Biosecurity · AUKarolinska Institutet · SERutgers, The State University of New Jersey · USSaarland University · DETufts University · USUniversity of Oslo · NOUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Identification of modifiable risk factors provides a crucial approach to the prevention of dementia. Nutritional or nutrient-dependent risk factors are especially important because dietary modifications or use of dietary supplements may lower the risk factor level. One such risk factor is a raised concentration of the biomarker plasma total homocysteine, which reflects the functional status of three B vitamins (folate, vitamins B12, B6). A group of experts reviewed literature evidence from the last 20 years. We here present a Consensus Statement, based on the Bradford Hill criteria, and conclude that elevated plasma total homocysteine is a modifiable risk factor for development of cognitive decline, dementia, and Alzheimer's disease in older persons. In a variety of clinical studies, the relative risk of dementia in elderly people for moderately raised homocysteine (within the normal range) ranges from 1.15 to 2.5, and the Population Attributable risk ranges from 4.3 to 31%. Intervention trials in elderly with cognitive impairment show that homocysteine-lowering treatment with B vitamins markedly slows the rate of whole and regional brain atrophy and also slows cognitive decline. The findings are consistent with moderately raised plasma total homocysteine (>11 μmol/L), which is common in the elderly, being one of the causes of age-related cognitive decline and dementia. Thus, the public health significance of raised tHcy in the elderly should not be underestimated, since it is easy, inexpensive, and safe to treat with B vitamins. Further trials are needed to see whether B vitamin treatment will slow, or prevent, conversion to dementia in people at risk of cognitive decline or dementia.

Indexed as

Cognitive DysfunctionDementiaDietary SupplementsHomocysteineVitamin B ComplexCognitionHumansMeta-Analysis as TopicReview Literature as TopicRisk FactorsHomocysteineVitamin B ComplexAlzheimer’s diseasebrain atrophycausationcobalamincognitive impairmentdementiafolateHomocysteinerisk-factorvitamin B12vitamin B6

Identifiers

PMID29480200
PMCPMC5836397
OpenAlexW2789200606

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.