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Homocysteine and folate as risk factors for dementia and Alzheimer disease.
Am J Clin Nutr 2005; 82(3):636-43AJ

Abstract

BACKGROUND

In cross-sectional studies, elevated plasma total homocysteine (tHcy) concentrations have been associated with cognitive impairment and dementia. Incidence studies of this issue are few and have produced conflicting results.

OBJECTIVE

We investigated the relation between high plasma tHcy concentrations and risk of dementia and Alzheimer disease (AD) in an elderly population.

DESIGN

A dementia-free cohort of 816 subjects (434 women and 382 men; mean age: 74 y) from an Italian population-based study constituted our study sample. The relation of baseline plasma tHcy to the risk of newly diagnosed dementia and AD on follow-up was examined. A proportional hazards regression model was used to adjust for age, sex, education, apolipoprotein E genotype, vascular risk factors, and serum concentrations of folate and vitamin B-12.

RESULTS

Over an average follow-up of 4 y, dementia developed in 112 subjects, including 70 who received a diagnosis of AD. In the subjects with hyperhomocysteinemia (plasma tHcy > 15 micromol/L), the hazard ratio for dementia was 2.08 (95% CI: 1.31, 3.30; P = 0.002). The corresponding hazard ratio for AD was 2.11 (95% CI: 1.19, 3.76; P = 0.011). Independently of hyperhomocysteinemia and other confounders, low folate concentrations (< or = 11.8 nmol/L) were also associated with an increased risk of both dementia (1.87; 95% CI: 1.21, 2.89; P = 0.005) and AD (1.98; 95% CI: 1.15, 3.40; P = 0.014), whereas the association was not significant for vitamin B-12.

CONCLUSIONS

Elevated plasma tHcy concentrations and low serum folate concentrations are independent predictors of the development of dementia and AD.

Authors+Show Affiliations

Department of Internal Medicine, Cardioangiology, and Hepatology, University Hospital S Orsola-Malpighi, Bologna, Italy. ravaglia@med.unibo.itNo affiliation info availableNo 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

Language

eng

PubMed ID

16155278

Citation

Ravaglia, Giovanni, et al. "Homocysteine and Folate as Risk Factors for Dementia and Alzheimer Disease." The American Journal of Clinical Nutrition, vol. 82, no. 3, 2005, pp. 636-43.
Ravaglia G, Forti P, Maioli F, et al. Homocysteine and folate as risk factors for dementia and Alzheimer disease. Am J Clin Nutr. 2005;82(3):636-43.
Ravaglia, G., Forti, P., Maioli, F., Martelli, M., Servadei, L., Brunetti, N., ... Licastro, F. (2005). Homocysteine and folate as risk factors for dementia and Alzheimer disease. The American Journal of Clinical Nutrition, 82(3), pp. 636-43.
Ravaglia G, et al. Homocysteine and Folate as Risk Factors for Dementia and Alzheimer Disease. Am J Clin Nutr. 2005;82(3):636-43. PubMed PMID: 16155278.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Homocysteine and folate as risk factors for dementia and Alzheimer disease. AU - Ravaglia,Giovanni, AU - Forti,Paola, AU - Maioli,Fabiola, AU - Martelli,Mabel, AU - Servadei,Lucia, AU - Brunetti,Nicoletta, AU - Porcellini,Elisa, AU - Licastro,Federico, PY - 2005/9/13/pubmed PY - 2005/11/3/medline PY - 2005/9/13/entrez SP - 636 EP - 43 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 82 IS - 3 N2 - BACKGROUND: In cross-sectional studies, elevated plasma total homocysteine (tHcy) concentrations have been associated with cognitive impairment and dementia. Incidence studies of this issue are few and have produced conflicting results. OBJECTIVE: We investigated the relation between high plasma tHcy concentrations and risk of dementia and Alzheimer disease (AD) in an elderly population. DESIGN: A dementia-free cohort of 816 subjects (434 women and 382 men; mean age: 74 y) from an Italian population-based study constituted our study sample. The relation of baseline plasma tHcy to the risk of newly diagnosed dementia and AD on follow-up was examined. A proportional hazards regression model was used to adjust for age, sex, education, apolipoprotein E genotype, vascular risk factors, and serum concentrations of folate and vitamin B-12. RESULTS: Over an average follow-up of 4 y, dementia developed in 112 subjects, including 70 who received a diagnosis of AD. In the subjects with hyperhomocysteinemia (plasma tHcy > 15 micromol/L), the hazard ratio for dementia was 2.08 (95% CI: 1.31, 3.30; P = 0.002). The corresponding hazard ratio for AD was 2.11 (95% CI: 1.19, 3.76; P = 0.011). Independently of hyperhomocysteinemia and other confounders, low folate concentrations (< or = 11.8 nmol/L) were also associated with an increased risk of both dementia (1.87; 95% CI: 1.21, 2.89; P = 0.005) and AD (1.98; 95% CI: 1.15, 3.40; P = 0.014), whereas the association was not significant for vitamin B-12. CONCLUSIONS: Elevated plasma tHcy concentrations and low serum folate concentrations are independent predictors of the development of dementia and AD. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/16155278/Homocysteine_and_folate_as_risk_factors_for_dementia_and_Alzheimer_disease_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn.82.3.636 DB - PRIME DP - Unbound Medicine ER -