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Homocysteine versus the vitamins folate, B6, and B12 as predictors of cognitive function and decline in older high-functioning adults: MacArthur Studies of Successful Aging.
Am J Med 2005; 118(2):161-7AJ

Abstract

BACKGROUND

Elevated plasma total homocysteine concentration may be a risk factor for cognitive decline and Alzheimer disease, but data from prospective studies are limited. Further, high homocysteine levels are associated with low vitamin status, and it is unknown whether it is homocysteine toxicity or vitamin insufficiency that is responsible for the observed cognitive dysfunction.

METHODS

We performed cross-sectional and longitudinal analyses of a cohort of 499 high-functioning community-dwelling persons aged 70 to 79 years to determine the effect of homocysteine and related vitamin plasma concentrations on cognitive function and cognitive decline. Nonfasting plasma concentrations of homocysteine, folate, vitamin B(6), and vitamin B(12) were measured at baseline. Summary measures of cognitive function were created from tests of multiple cognitive domains administered at baseline and again after 7 years.

RESULTS

In cross-sectional analyses investigating each variable separately, subjects with elevated homocysteine levels, or low levels of folate or vitamin B(6), demonstrated worse baseline cognitive function. In longitudinal analyses, after adjusting for multiple covariates, including homocysteine, those in the bottom quartile of folate had a 1.6-fold increased risk (95% confidence interval: 1.01 to 2.31; P =0.04) of being in the worst quartile of 7-year cognitive decline. Low folate levels largely accounted for a trend towards greater cognitive decline with elevated homocysteine level.

CONCLUSION

In high-functioning older adults, low folate levels appear to be a risk factor for cognitive decline. The risk of developing cognitive decline might be reduced through dietary folate intake.

Authors+Show Affiliations

Division of Geriatrics, Department of Medicine, The David Geffen School of Medicine at University of California Los Angeles, 90095, USA. dkado@mednet.ucla.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15694902

Citation

Kado, Deborah M., et al. "Homocysteine Versus the Vitamins Folate, B6, and B12 as Predictors of Cognitive Function and Decline in Older High-functioning Adults: MacArthur Studies of Successful Aging." The American Journal of Medicine, vol. 118, no. 2, 2005, pp. 161-7.
Kado DM, Karlamangla AS, Huang MH, et al. Homocysteine versus the vitamins folate, B6, and B12 as predictors of cognitive function and decline in older high-functioning adults: MacArthur Studies of Successful Aging. Am J Med. 2005;118(2):161-7.
Kado, D. M., Karlamangla, A. S., Huang, M. H., Troen, A., Rowe, J. W., Selhub, J., & Seeman, T. E. (2005). Homocysteine versus the vitamins folate, B6, and B12 as predictors of cognitive function and decline in older high-functioning adults: MacArthur Studies of Successful Aging. The American Journal of Medicine, 118(2), pp. 161-7.
Kado DM, et al. Homocysteine Versus the Vitamins Folate, B6, and B12 as Predictors of Cognitive Function and Decline in Older High-functioning Adults: MacArthur Studies of Successful Aging. Am J Med. 2005;118(2):161-7. PubMed PMID: 15694902.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Homocysteine versus the vitamins folate, B6, and B12 as predictors of cognitive function and decline in older high-functioning adults: MacArthur Studies of Successful Aging. AU - Kado,Deborah M, AU - Karlamangla,Arun S, AU - Huang,Mei-Hua, AU - Troen,Aron, AU - Rowe,John W, AU - Selhub,Jacob, AU - Seeman,Teresa E, PY - 2004/01/26/received PY - 2004/08/10/accepted PY - 2005/2/8/pubmed PY - 2005/3/3/medline PY - 2005/2/8/entrez SP - 161 EP - 7 JF - The American journal of medicine JO - Am. J. Med. VL - 118 IS - 2 N2 - BACKGROUND: Elevated plasma total homocysteine concentration may be a risk factor for cognitive decline and Alzheimer disease, but data from prospective studies are limited. Further, high homocysteine levels are associated with low vitamin status, and it is unknown whether it is homocysteine toxicity or vitamin insufficiency that is responsible for the observed cognitive dysfunction. METHODS: We performed cross-sectional and longitudinal analyses of a cohort of 499 high-functioning community-dwelling persons aged 70 to 79 years to determine the effect of homocysteine and related vitamin plasma concentrations on cognitive function and cognitive decline. Nonfasting plasma concentrations of homocysteine, folate, vitamin B(6), and vitamin B(12) were measured at baseline. Summary measures of cognitive function were created from tests of multiple cognitive domains administered at baseline and again after 7 years. RESULTS: In cross-sectional analyses investigating each variable separately, subjects with elevated homocysteine levels, or low levels of folate or vitamin B(6), demonstrated worse baseline cognitive function. In longitudinal analyses, after adjusting for multiple covariates, including homocysteine, those in the bottom quartile of folate had a 1.6-fold increased risk (95% confidence interval: 1.01 to 2.31; P =0.04) of being in the worst quartile of 7-year cognitive decline. Low folate levels largely accounted for a trend towards greater cognitive decline with elevated homocysteine level. CONCLUSION: In high-functioning older adults, low folate levels appear to be a risk factor for cognitive decline. The risk of developing cognitive decline might be reduced through dietary folate intake. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/15694902/Homocysteine_versus_the_vitamins_folate_B6_and_B12_as_predictors_of_cognitive_function_and_decline_in_older_high_functioning_adults:_MacArthur_Studies_of_Successful_Aging_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(04)00665-5 DB - PRIME DP - Unbound Medicine ER -