Abstract Introduction: To respond to the threat of dementia to public health and the economy, we need to
prioritize research resources on strategies that would be the most effective. In relation to the prevention
of dementia, this article considers whether lowering plasma homocysteine by B-vitamin supplementation
is one of the top priority and cost-effective treatments.
Method: A decision model was constructed to calculate the lifetime costs and quality-adjusted life
years (QALYs) of providing B-vitamin treatment to people in the United Kingdom over 60 years with
high levels (.13 mmol/L) of plasma homocysteine, which was compared to the lifetime costs and
outcomes of not providing them with the treatment.
Results: TreatmentwithB-vitaminswill save£60,021 perQALYgained and so is highly cost-effective.
Discussion: We anticipate that this provocative finding will be debated by scientists, clinicians, and
policy makers and eventually be tested in future clinical trials.
2016 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer’s Association. This
is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/
by-nc-nd/4.0/).