Folate and cobalamin synergistically decrease the risk of high plasma homocysteine in a nonsupplemented elderly institutionalized population

Total plasma homocysteine (tHcy) has been associated with an increased risk of cardiovascular disease in the general population and elderly subjects are at high risk of elevated homocysteine because of an impaired vitamin status. The aim of the present study was to determine the independent and interactive association of adequate folate and cobalamin (intake and serum levels) with tHcy in elderly subjects who were not taking vitamin supplementation. Design and methods Cross-sectional analysis of a sample of 140 elderly recruited from seven nursing homes in Asturias (Northern Spain). Dietary intake was assessed by a food frequency questionnaire, and serum folate, cobalamin, and tHcy were determined in fasting blood samples. Results Mean tHcy concentration was 13.3 μmol/L (upper quartile of tHcy >16.0 μmol/L) and was inversely correlated with serum folate. Subjects with an adequate intake or serum levels of both folate and B12 were at a reduced risk of being in the highest quartile of tHcy. In both cases, the reduction of high tHcy (upper quartile) risk was found to be greater than expected when subjects with high levels of both vitamins were considered together. Conclusions Adequate folate and cobalamin (both intake and serum levels) act synergistically to decrease the risk of high total plasma homocysteine levels in this elderly population.