Relationship of white matter lesions with clinical features and vitamin B12, vitamin D folate, and homocysteine levels in Alzheimer's patients

Background: Alzheimer's disease is a progressive neurodegenerative disorder. White matter lesions (WMLs) are commonly observed in elderly individuals, detected through magnetic resonance imaging (MRI), and graded using the Fazekas scale. These lesions are known to be associated with vascular and metabolic risk factors. This study aimed to investigate the relationship between clinical findings and Fazekas score, as well as serum levels of vitamin B12, folate, vitamin D, and homocysteine in patients with Alzheimer's disease. Methods: This retrospective study included 142 patients diagnosed with Alzheimer's disease. Patients were grouped based on Fazekas scores (0-1-2-3). Mini- Mental State Examination (MMSE) scores and serum levels of vitamin B12, folate, vitamin D, and homocysteine were compared across the groups. Results: Patients with a Fazekas score of 3 had significantly higher homocysteine levels (p < 0.05). However, no significant correlation was found between MMSE scores and Fazekas grades. Approximately 25% of patients had folate levels below 6.16 ng/mL, and most had vitamin D levels below 20 ng/mL. Conclusion: Elevated homocysteine levels may contribute to white matter damage and cognitive dysfunction in Alzheimer's disease. Monitoring vitamin levels and integrating these biomarkers with neuroimaging and cognitive assessments may represent a potential strategy for slowing neurodegenerative progression. Keywords: Alzheimer's disease, Fazekas score, homocysteine, vitamin B12, vitamin D, folate