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Homocysteine and folate as risk factors for dementia and Alzheimer disease.

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.

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  • Authors+Show Affiliations

    ,

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

    , , , , , ,

    Source

    MeSH

    Aged
    Aging
    Alzheimer Disease
    Cognition
    Cohort Studies
    Cross-Sectional Studies
    Dementia
    Female
    Folic Acid
    Follow-Up Studies
    Homocysteine
    Humans
    Italy
    Male
    Prospective Studies
    Risk Factors
    Seroepidemiologic Studies

    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 -