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Oulhaj A et al. - Raised homocysteine concentrations within the normal range among the elderly strongly relate to the rate of global cognitive decline in patients with Alzheimer disease. Plasma homocysteine can readily be lowered by B-vitamin treatment and trials should be carried out to see if such treatments can slow the rate of cognitive decline in relatively young patients with Alzheimer disease.

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Exclusive Author Commentary
A. David Smith, 06/03/09

The findings have two main clinical implications: first, a high baseline homocysteine level can be used to predict that a patient is likely to decline more rapidly; second, since homocysteine levels can be lowered by B vitamin treatment, trials should be initiated on Alzheimer patients who are aged less than 75 to see if lowering homocysteine can slow disease progression. Whether or not high homocysteine is causal, it is certainly a good prognostic marker.

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