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Increased Total Homocysteine Levels Predict the Risk of Incident Dementia Independent of Cerebral Small-Vessel Diseases and Vascular Risk Factors.
J Alzheimers Dis. 2016; 49(2):503-13.JA

Abstract

BACKGROUND

Homocysteine has been identified as a potential risk factor for stroke, cerebral small-vessel diseases (SVD), and dementia.

OBJECTIVE

The present study aimed to investigate the predictive value of homocysteine levels on incident dementia while simultaneously controlling for MRI findings and vascular risk factors.

METHODS

Within a Japanese cohort of participants with vascular risk factors in an observational study, we evaluated the association between baseline total homocysteine (tHcy) levels (per 1 μmol/L and the tertile of tHcy), the prevalence of MRI-findings at baseline, and incident all-cause dementia. Baseline brain MRI was used to determine SVD (lacunas, white matter hyperintensities, and cerebral microbleeds [CMBs]) and atrophy (medial-temporal lobe atrophy and bicaudate ratio). Logistic regression analyses were used to estimate the cross-sectional association between tHcy and each of MRI findings. Cox proportional hazards analyses were performed to estimate the longitudinal association between tHcy and dementia.

RESULTS

In the 643 subjects (age: 67.2 ± 8.4 years, male: 59% ; education: 12.9 ± 2.6 years), multivariable analyses adjusted for several potential confounders, including estimated glomerular filtration rate (eGFR) and intima-media thickness, showed that highest tHcy tertile was associated with lacunas, CMBs, and strictly deep CMBs. During the mean 7.3-year follow-up (range: 2-13), 47 patients were diagnosed with dementia (Alzheimer's disease: 24; vascular dementia: 18; mixed-type: 3; other: 2). After adjusting for age, gender, APOE ɛ4, education, BMI, MMSE, hypertension, cerebrovascular events, eGFR, and MRI-findings, tHcy level (hazard ratios [HR]: 1.08, p = 0.043) and the highest tertile of tHcy (HR: 2.50, p = 0.047) for all-cause dementia remained significant.

CONCLUSIONS

Our results provide additional evidence of tHcy that contributes to increased susceptibility to dementia risk.

Authors+Show Affiliations

Department of Neurology and Stroke Center, Osaka University Graduate School of Medicine, Osaka, Japan.Department of Strokology, Stroke Center, Hoshigaoka Medical Center, Osaka, Japan.Department of Neurology and Stroke Center, Osaka University Graduate School of Medicine, Osaka, Japan.Department of Stroke Medicine, Kawasaki Medical University, Kurashiki, Japan.Department of Neurology and Stroke Center, Osaka University Graduate School of Medicine, Osaka, Japan.Department of Neurology and Stroke Center, Osaka University Graduate School of Medicine, Osaka, Japan.Department of Neurology, Tokyo Women's Medical University, Tokyo, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26484913

Citation

Miwa, Kaori, et al. "Increased Total Homocysteine Levels Predict the Risk of Incident Dementia Independent of Cerebral Small-Vessel Diseases and Vascular Risk Factors." Journal of Alzheimer's Disease : JAD, vol. 49, no. 2, 2016, pp. 503-13.
Miwa K, Tanaka M, Okazaki S, et al. Increased Total Homocysteine Levels Predict the Risk of Incident Dementia Independent of Cerebral Small-Vessel Diseases and Vascular Risk Factors. J Alzheimers Dis. 2016;49(2):503-13.
Miwa, K., Tanaka, M., Okazaki, S., Yagita, Y., Sakaguchi, M., Mochizuki, H., & Kitagawa, K. (2016). Increased Total Homocysteine Levels Predict the Risk of Incident Dementia Independent of Cerebral Small-Vessel Diseases and Vascular Risk Factors. Journal of Alzheimer's Disease : JAD, 49(2), 503-13. https://doi.org/10.3233/JAD-150458
Miwa K, et al. Increased Total Homocysteine Levels Predict the Risk of Incident Dementia Independent of Cerebral Small-Vessel Diseases and Vascular Risk Factors. J Alzheimers Dis. 2016;49(2):503-13. PubMed PMID: 26484913.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased Total Homocysteine Levels Predict the Risk of Incident Dementia Independent of Cerebral Small-Vessel Diseases and Vascular Risk Factors. AU - Miwa,Kaori, AU - Tanaka,Makiko, AU - Okazaki,Shuhei, AU - Yagita,Yoshiki, AU - Sakaguchi,Manabu, AU - Mochizuki,Hideki, AU - Kitagawa,Kazuo, PY - 2015/10/21/entrez PY - 2015/10/21/pubmed PY - 2016/9/13/medline KW - Alzheimer’s disease KW - cerebral small-vessel disease KW - dementia KW - estimated glomerular filtration rate KW - homocysteine KW - microbleeds KW - vascular dementia SP - 503 EP - 13 JF - Journal of Alzheimer's disease : JAD JO - J Alzheimers Dis VL - 49 IS - 2 N2 - BACKGROUND: Homocysteine has been identified as a potential risk factor for stroke, cerebral small-vessel diseases (SVD), and dementia. OBJECTIVE: The present study aimed to investigate the predictive value of homocysteine levels on incident dementia while simultaneously controlling for MRI findings and vascular risk factors. METHODS: Within a Japanese cohort of participants with vascular risk factors in an observational study, we evaluated the association between baseline total homocysteine (tHcy) levels (per 1 μmol/L and the tertile of tHcy), the prevalence of MRI-findings at baseline, and incident all-cause dementia. Baseline brain MRI was used to determine SVD (lacunas, white matter hyperintensities, and cerebral microbleeds [CMBs]) and atrophy (medial-temporal lobe atrophy and bicaudate ratio). Logistic regression analyses were used to estimate the cross-sectional association between tHcy and each of MRI findings. Cox proportional hazards analyses were performed to estimate the longitudinal association between tHcy and dementia. RESULTS: In the 643 subjects (age: 67.2 ± 8.4 years, male: 59% ; education: 12.9 ± 2.6 years), multivariable analyses adjusted for several potential confounders, including estimated glomerular filtration rate (eGFR) and intima-media thickness, showed that highest tHcy tertile was associated with lacunas, CMBs, and strictly deep CMBs. During the mean 7.3-year follow-up (range: 2-13), 47 patients were diagnosed with dementia (Alzheimer's disease: 24; vascular dementia: 18; mixed-type: 3; other: 2). After adjusting for age, gender, APOE ɛ4, education, BMI, MMSE, hypertension, cerebrovascular events, eGFR, and MRI-findings, tHcy level (hazard ratios [HR]: 1.08, p = 0.043) and the highest tertile of tHcy (HR: 2.50, p = 0.047) for all-cause dementia remained significant. CONCLUSIONS: Our results provide additional evidence of tHcy that contributes to increased susceptibility to dementia risk. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/26484913/Increased_Total_Homocysteine_Levels_Predict_the_Risk_of_Incident_Dementia_Independent_of_Cerebral_Small_Vessel_Diseases_and_Vascular_Risk_Factors_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JAD-150458 DB - PRIME DP - Unbound Medicine ER -