Homocysteine and Dementias

Homocysteine is a simple amino acid that has recently received a great deal of attention as a risk factor for atherothrombotic vascular disease. There is reasonably compelling epidemiologic evidence of an association between the plasma homocysteine level and the risk of vascular disease in the coronary, carotid, and peripheral circulations. The mechanisms by which hyperhomocysteinemia promotes atherosclerosis are less clear. They may include oxidative injury to the vascular wall, vascular-cell proliferation, and the development of a prothrombotic state.In this issue of the Journal (see pages 476–483), Seshadri and colleagues provide convincing evidence that, in elderly persons, elevated plasma levels . . .