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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

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Volume 43, Issue 10 (Oct 2005)


Homocysteine and B vitamins in mild cognitive impairment and dementia

Pierluigi Quadri
  • Geriatric Division and Department of Metabolic Diseases, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland
/ Claudia Fragiacomo
  • Geriatric Division and Department of Metabolic Diseases, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland
/ Rita Pezzati
  • Geriatric Division and Department of Metabolic Diseases, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland
/ Enrica Zanda
  • Geriatric Division and Department of Metabolic Diseases, Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland
/ Mauro Tettamanti
  • Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy
/ Ugo Lucca
  • Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy


Elderly subjects with mild cognitive impairment have a high risk for conversion to Alzheimer's disease or are already in a preclinical dementia stage. By cross-sectionally comparing subjects in prodromal and early phases of dementia with non-demented controls, we tested the hypothesis whether low serum vitamin B12 and folate and high plasma total homocysteine concentrations precede or are a consequence of dementia onset. From a large population of 623 consecutive subjects seen at the Memory Clinic (Ospedale Beata Vergine, Mendrisio, Switzerland), 433 subjects could be included in the analyses: 79 elderly controls, 218 Clinical Dementia Rating 0.5 subjects, and 136 demented patients (111 with Alzheimer's disease and 25 with vascular dementia). As in an earlier report on a smaller sample of the same population (n=228), the lowest folate tertile was strongly associated with mild cognitive impairment (adjusted OR=3.1) and Alzheimer's disease (adjusted OR=4.0). Hyperhomocysteinemia showed a significant association not only with Alzheimer's disease (adjusted OR=3.1) but, at variance with the previous report, also with mild cognitive impairment (adjusted OR=2.6). Present reanalysis results suggest that subclinical folate deficiency and hyperhomocysteinemia might predate dementia onset, findings to be confirmed by longitudinal studies.

Keywords: Alzheimer's disease; dementia; folate; homocysteine; mild cognitive impairment; vitamin B12


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About the article

Corresponding author: Ugo Lucca, Laboratory of Geriatric Neuropsychiatry, Istituto di Ricerche Farmacologiche “Mario Negri”, Via Eritrea 62, 20157 Milan, Italy Phone: +39-02-3901-4427, Fax: +39-02-3900-1916,

Published in Print: 2005-10-01

Citation Information: Clinical Chemical Laboratory Medicine, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2005.191. Export Citation

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