Hyperhomocysteinemia is a risk factor for both ischemic stroke and osteoporotic fractures in elderly men and women.

Folate and vitamin B12 reduce homocysteine levels.

In Japanese population with a high baseline fracture risk, combined treatment with folate and vitamin B12 is safe and effective in reducing the risk of a hip fracture in elderly patients following stroke.

A Japanese study investigated whether treatment with folate and vitamin B12 reduces the incidence of hip fractures in patients with hemiplegia following stroke.

The patients were assigned to daily oral treatment with 5 mg of folate and 1500 microg of mecobalamin ( vitamin B12 ), or double placebo; 559 completed the 2-year follow-up.

After 2 years, plasma homocysteine levels decreased by 38% in the treatment group and increased by 31% in the placebo group ( P<.001 ).

The number of hip fractures per 1000 patient-years was 10 and 43 for the treatment and placebo groups, respectively ( P<.001 ).

The adjusted relative risk, absolute risk reduction, and the number needed to treat for hip fractures in the treatment vs placebo groups were 0.20, 7.1%, and 14, respectively.

Source : JAMA, 2005

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