Prime

Type your tag names separated by a space and hit enter

Plasma homocysteine as a risk factor for dementia and Alzheimer's disease.

Abstract

BACKGROUND

In cross-sectional studies, elevated plasma homocysteine levels have been associated with poor cognition and dementia. Studies of newly diagnosed dementia are required in order to establish whether the elevated homocysteine levels precede the onset of dementia or result from dementia-related nutritional and vitamin deficiencies.

METHODS

A total of 1092 subjects without dementia (667 women and 425 men; mean age, 76 years) from the Framingham Study constituted our study sample. We examined the relation of the plasma total homocysteine level measured at base line and that measured eight years earlier to the risk of newly diagnosed dementia on follow-up. We used multivariable proportional-hazards regression to adjust for age, sex, apolipoprotein E genotype, vascular risk factors other than homocysteine, and plasma levels of folate and vitamins B12 and B6.

RESULTS

Over a median follow-up period of eight years, dementia developed in 111 subjects, including 83 given a diagnosis of Alzheimer's disease. The multivariable-adjusted relative risk of dementia was 1.4 (95 percent confidence interval, 1.1 to 1.9) for each increase of 1 SD in the log-transformed homocysteine value either at base line or eight years earlier. The relative risk of Alzheimer's disease was 1.8 (95 percent confidence interval, 1.3 to 2.5) per increase of 1 SD at base line and 1.6 (95 percent confidence interval, 1.2 to 2.1) per increase of 1 SD eight years before base line. With a plasma homocysteine level greater than 14 micromol per liter, the risk of Alzheimer's disease nearly doubled.

CONCLUSIONS

An increased plasma homocysteine level is a strong, independent risk factor for the development of dementia and Alzheimer's disease.

Links

  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Neurology, Boston University School of Medicine, MA 02118-2526, USA.

    , , , , , ,

    Source

    The New England journal of medicine 346:7 2002 Feb 14 pg 476-83

    MeSH

    Aged
    Aged, 80 and over
    Alzheimer Disease
    Apolipoproteins E
    Cohort Studies
    Confounding Factors (Epidemiology)
    Dementia
    Female
    Homocysteine
    Humans
    Hyperhomocysteinemia
    Male
    Multivariate Analysis
    Proportional Hazards Models
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    11844848

    Citation

    TY - JOUR T1 - Plasma homocysteine as a risk factor for dementia and Alzheimer's disease. AU - Seshadri,Sudha, AU - Beiser,Alexa, AU - Selhub,Jacob, AU - Jacques,Paul F, AU - Rosenberg,Irwin H, AU - D'Agostino,Ralph B, AU - Wilson,Peter W F, AU - Wolf,Philip A, PY - 2002/2/15/pubmed PY - 2002/3/19/medline PY - 2002/2/15/entrez SP - 476 EP - 83 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 346 IS - 7 N2 - BACKGROUND: In cross-sectional studies, elevated plasma homocysteine levels have been associated with poor cognition and dementia. Studies of newly diagnosed dementia are required in order to establish whether the elevated homocysteine levels precede the onset of dementia or result from dementia-related nutritional and vitamin deficiencies. METHODS: A total of 1092 subjects without dementia (667 women and 425 men; mean age, 76 years) from the Framingham Study constituted our study sample. We examined the relation of the plasma total homocysteine level measured at base line and that measured eight years earlier to the risk of newly diagnosed dementia on follow-up. We used multivariable proportional-hazards regression to adjust for age, sex, apolipoprotein E genotype, vascular risk factors other than homocysteine, and plasma levels of folate and vitamins B12 and B6. RESULTS: Over a median follow-up period of eight years, dementia developed in 111 subjects, including 83 given a diagnosis of Alzheimer's disease. The multivariable-adjusted relative risk of dementia was 1.4 (95 percent confidence interval, 1.1 to 1.9) for each increase of 1 SD in the log-transformed homocysteine value either at base line or eight years earlier. The relative risk of Alzheimer's disease was 1.8 (95 percent confidence interval, 1.3 to 2.5) per increase of 1 SD at base line and 1.6 (95 percent confidence interval, 1.2 to 2.1) per increase of 1 SD eight years before base line. With a plasma homocysteine level greater than 14 micromol per liter, the risk of Alzheimer's disease nearly doubled. CONCLUSIONS: An increased plasma homocysteine level is a strong, independent risk factor for the development of dementia and Alzheimer's disease. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/11844848/full_citation L2 - http://www.nejm.org/doi/abs/10.1056/NEJMoa011613?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed ER -