Homocysteine and cognitive impairment; a case series in a General Practice setting.
BACKGROUND
An elevated blood level of homocysteine is a risk factor for cognitive impairment and dementia. Homocysteine can be lowered by folate and/or vitamin B12 supplementation; antioxidants might also be required for optimal reduction in neurovascular tissue. This report presents clinical and radiological findings from administering the antioxidant N-acetylcysteine together with B vitamins to cognitively impaired patients with hyperhomocysteinaemia.


METHODS
A case series (n = 7) performed in a semi-rural General Practice setting. Formal cognitive assessments were performed in five patients, and radiological assessments in one patient, before and after supplementation.


CONCLUSIONS
The addition of N-acetylcysteine resulted in subjective clinical improvement in all patients, and an objective improvement in cognitive scores in five patients. One patient had radiological evidence of halted disease progression over a twelve month period.


CONCLUSIONS
N-acetylcysteine, together with B vitamin supplements, improves cognitive status in hyperhomocysteinaemic patients. Randomized controlled clinical trials are required to formally evaluate this treatment approach.
McCaddon
Andrew
A
Wales College of Medicine, Wrexham, UK. andrew@mccaddon.demon.co.uk
D000111:Acetylcysteine / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000008:administration & dosage; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology*; D005194:Family Practice; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D008297:Male; D008569:Memory Disorders / Q000188:drug therapy; D008570:Memory, Short-Term; D011859:Radiography; D014805:Vitamin B 12 / Q000008:administration & dosage; D014806:Vitamin B 12 Deficiency / Q000150:complications / Q000188:drug therapy; D014803:Vitamin B Complex / Q000008:administration & dosage
D000975:Antioxidants; D014803:Vitamin B Complex; D005492:Folic Acid; D014805:Vitamin B 12; D000111:Acetylcysteine