In 2015, there were about 47 million people were living with dementia around the world. This number is projected to triple by 2050. With these kinds of figures, it’s safe to say that Dementia is the greatest global challenge for health and social care in the 21st century. In a recent commission published by the Lancet, a list of 9 modifiable risk factors were outlined:

Mid-life hearing loss – responsible for 9% of the risk
Failing to complete secondary education – 8%
Smoking – 5%
Failing to seek early treatment for depression – 4%
Physical inactivity – 3%
Social isolation – 2%
High blood pressure – 2%
Obesity – 1%
Type 2 diabetes – 1%


It’s great to see that lifestyle factors such as physical activity and social isolation are being highlighted in the report. At Food for the Brain, our Positive Action on Alzheimer’s campaign has for many years been generating awareness about the importance of keeping active and engaging in social activities to help keep the brain healthy. However, we were disappointed to see that despite the research that demonstrates raised homocysteine levels as a significant risk factor, it has not been listed and was not acknowledged in the Lancet commission. Professor David Smith, is the chair of our scientific advisory panel and a pioneer in researching the use of B vitamins to lower homocysteine and improve cognitive health. There are some key studies which he felt important to draw our readership’s attention to in support of this argument:
In a meta-analysis published in 2014 by BMC Public Health, raised homocysteine was considered to be one of the three strongest risk factors, along with low education and decreased physical activity. In addition, two further trials have clearly shown that lowering homocysteine, through the supplementation of B vitamins, reduced age-related cognitive decline in normal ageing and slowed down both brain atrophy and cognitive decline in people with Mild Cognitive Impairment

Furthermore, the Lancet Commission on Dementia, made an error in its reference to one of the key trials by VITACOG, a two-year randomised, placebo-controlled pilot trial that was developed as part of the Oxford Project to Investigate Memory and Ageing (OPTIMA) The Lancet stated that the use of B vitamins (specifically B6, folate and B12) ‘had no significant effect on global cognition’, which contradicts the findings of the paper that reported a highly significant slowing of global cognitive decline in the B vitamin treated group who has raised baseline plasma homocysteine. 

Our charity, Food for the Brain, aims to empower people to take their cognitive health into their own hands by generating awareness about the evidence that shows how a balanced diet and having healthy homocysteine levels can help arrest and prevent the development of Alzheimer’s.

References:
Dementia Prevention, Intervention and Care, The Lancet Commission, 19th July 2017

Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health. 2014 Jun

Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet 2007 Jan

Cognitive and clinical outcomes of homocysteine-lowering B-vitamin treatment in mild cognitive impairment: a randomized controlled trial. Int J Geriatr Psychiatry 2012

Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS One. 2010 Sep

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