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A trial of B vitamins and cognitive function among women at high risk of cardiovascular disease.

AbstractBACKGROUND:
High homocysteine concentrations may be neurotoxic and contribute to cognitive decline in older persons.
OBJECTIVE:
The objective was to examine the effect of supplementation with folic acid, vitamin B-12, and vitamin B-6 on cognitive change in women with cardiovascular disease (CVD) or CVD risk factors.
DESIGN:
The Women's Antioxidant and Folic Acid Cardiovascular Study is a randomized placebo-controlled trial designed to test the effect of a combination of B vitamins (2.5 mg folic acid/d, 50 mg vitamin B-6/d, and 1 mg vitamin B-12/d) on secondary prevention of CVD. Female health professionals aged >or=40 y (n = 5442) with CVD or >or=3 coronary risk factors in 1998 (after folic acid fortification began in the United States) were randomly assigned to treatment. Shortly after randomization (mean: 1.2 y), a substudy of cognitive function was initiated among 2009 participants aged >or=65 y. Telephone cognitive function testing was administered up to 4 times over 5.4 y with 5 tests of general cognition, verbal memory, and category fluency. Repeated-measures analyses were conducted, and the primary outcome was a global composite score averaging all test results.
RESULTS:
Mean cognitive change from baseline did not differ between the B vitamin and placebo groups (difference in change in global score: 0.03; 95% CI: -0.03, 0.08; P = 0.30). However, supplementation appeared to preserve cognition among women with a low baseline dietary intake of B vitamins.
CONCLUSIONS:
Combined B vitamin supplementation did not delay cognitive decline among women with CVD or CVD risk factors. The possible cognitive benefits of supplementation among women with a low dietary intake of B vitamins warrant further study.
AuthorsJae Hee Kang, Nancy Cook, JoAnn Manson, Julie E Buring, Christine M Albert, Francine Grodstein
JournalThe American journal of clinical nutrition (Am J Clin Nutr) Vol. 88 Issue 6 Pg. 1602-10 (Dec 2008) ISSN: 1938-3207 [Electronic] United States
PMID19064521 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
Chemical References
  • Homocysteine
  • Vitamin B Complex
  • Vitamin B 6
  • Folic Acid
  • Vitamin B 12
Topics
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases (blood, epidemiology, prevention & control)
  • Chi-Square Distribution
  • Cognition (drug effects)
  • Cognition Disorders (blood, epidemiology, prevention & control)
  • Dietary Supplements
  • Double-Blind Method
  • Female
  • Folic Acid (administration & dosage)
  • Follow-Up Studies
  • Homocysteine (blood)
  • Humans
  • Hyperhomocysteinemia (complications)
  • Psychometrics
  • Risk Factors
  • Statistics, Nonparametric
  • Vitamin B 12 (administration & dosage)
  • Vitamin B 6 (administration & dosage)
  • Vitamin B Complex (administration & dosage)

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