Heart
Disease Marker
Now Tied to Alzheimer's
Excerpt
By Adam Marcus, HealthScoutNews
(HealthScoutNews) -- Large elevations in a blood molecule linked
to heart disease also appear to double the risk of developing
Alzheimer's disease and dementia.
A new study shows homocysteine is crucial for many of the body's
biochemical processes, and its levels increase with age. However,
the findings, which appear in tomorrow's issue of the New England
Journal of Medicine, also show that abnormally high levels of
the molecule, and large increases over time, strongly predict who
will develop dementia.
Taking folic acid and B vitamins can lower homocysteine, experts
say, though there's no evidence yet to suggest these dietary measures
can also reduce the risk of cognitive problems. However, researchers
are now studying whether taking supplements can slow cognitive
loss in those with mild and moderate Alzheimer's.
"We don't have that many risk or protective factors for
Alzheimer's disease," says Neil Buckholtz, a dementia expert
at the National Institute on Aging, which funded the latest study.
"Age is still the major risk factor that we know about, which
is clearly not modifiable."
A group led by Dr. Sudha Seshadri, a Boston University neurologist,
looked at 1,092 men and women who started a large study without
cognitive problems.
The subjects, whose average age was 76, were enrolled in an
ongoing research project called the Framingham Heart Study. Begun
in the 1940s, Framingham gave Seshadri and her colleagues access
to blood samples taken between 1979 and 1982, and again between
1986 and 1990.
Over roughly eight years of follow-up, 111 of the subjects developed
dementia, including 83 who were diagnosed with Alzheimer's. After
accounting for the effects of age and other factors, those with
elevated homocysteine levels at the second reading had about twice
the risk of dementia as subjects with normal readings for the
substance, the researchers say.
From earlier research, it was impossible to tell if elevated
homocysteine levels predicted or simply reflected brain disease.
"I think we have helped show that the homocysteine levels
increase well before the onset of clinical dementia," Seshadri
says.
Not all dementia is related to Alzheimer's; some results from
vessel damage and other illnesses. However, the researchers found
that elevated homocysteine appeared to boost the risk of cognitive
problems associated with both the degenerative brain disorder
and other forms of cognitive loss, Seshadri says.
Seshadri's group is now measuring current homocysteine levels
in their subjects to see if the increase persists in those with
dementia. They are also testing the children of Framingham study
participants for the compound, and plan to compare those results
to scores on cognitive tests and readings on brain scans.
As for why high homocysteine levels might be linked to brain
disease, "nobody really knows," Seshadri says.
Dr. Paul Aisen, a Georgetown University neurologist who's leading
the trial on vitamins, says some scientists have speculated homocysteine
might promote dementia by damaging blood vessels that feed the
brain. However, recent evidence suggests too much of the molecule
can directly harm brain cells, too.
Although Seshadri's study looked only at the impact of abnormally
high homocysteine levels, Aisen says some evidence indicates that
even slight elevations in the molecule might be detrimental.
"We hypothesize that the lower the homocysteine levels
the better," he says.
In his study, Aisen and his colleagues will give folic acid
and vitamins B12 and B6 to 400 Alzheimer's patients for 18 months.
"Our hypothesis is that by lowering homocysteine, we will
slow down the progression of Alzheimer's," he says.
What To Do
To find out more about homocysteine and the blood vessels, check
out the American
Academy of Family Physicians or the American
Heart Association.
Alzheimer's disease, which is thought to be caused by buildup
in the brain of protein plaques, affects an estimated 4 million
Americans. However, the number of patients is expected to swell
as the population ages. For more on the degenerative disorder,
try the Alzheimer's
Association.
Reference
Source 101
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