Inflammation and immune system activation seem to play an important role in the development and progression of
dementia.
Hyperhomocysteinemia is common in various forms of
dementia, and a significant relationship was found between concentrations of
homocysteine and immune activation marker
neopterin.
B vitamin supplementation is able to slow-down
homocysteine formation in patients. In an open-label study, effects of
B vitamin supplementation (Beneuran compositum ) on concentrations of
homocysteine and
neopterin were investigated in 58 patients with
Alzheimer's disease (
n=30),
vascular dementia (n=12) and
mild cognitive impairment (n=16). In all groups of patients, a significant percentage of patients presented with
homocysteine concentrations >15 micromol/L and with elevated concentrations of immune activation marker
neopterin. Decline of
homocysteine concentrations was observed after one month of
B vitamin supplementation (all p<0.01; paired Kruskal-Wallisn-test). By contrast,
neopterin concentrations remained unchanged (all p>0.05).
B vitamin supplementation in patients with various forms of
dementia did not influence
neopterin concentrations, which indicates that the degree of immune activation and
inflammation remained unchanged. The question remains, if lowering of
homocysteine by
folate supplementation alone could have any beneficial effect to modulate the course of
dementia development and if longer period of supplementation would also ameliorate immune system activation status.