Homocysteine and cognitive function in healthy elderly community dwellers in Italy
Homocysteine and cognitive function in healthy elderly community dwellers in Italy
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DOI:
10.1093/ajcn/77.3.668
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发表时间:
2003-03-01
影响因子:
7.1
通讯作者:
Mariani, E
中科院分区:
文献类型:
--
作者:
Ravaglia, G;Forti, P;Mariani, E
Background: Elevated plasma total homocysteine (tHcy) concentrations are common in the elderly and have been suggested to be a risk factor for dementia.Objective: In an elderly population, we examined the relation between plasma tHcy and scores on the Mini-Mental State Examination (MMSE), a commonly used screening measure of cognitive impairment in general practice.Design: Fasting plasma tHcy concentrations were measured in 650 healthy, cognitively normal Italian community dwellers aged greater than or equal to 65 y ((x) over bar +/- SD: 72.8 +/- 6.0 y). Socioeconomic status; serum folate, vitamin B-12, and creatinine; other potential dietary and lifestyle determinants of tHcy; and conventional vascular disease risk factors were also assessed.Results: Subjects with MMSE scores of 26-28 had higher plasma tHcy concentrations (12.7 mumol/L; range: 12.2-13.2 mumol/L) than did those with scores > 28 (11.9 mumol/L; 11.4-12.3 mumol/L; P < 0.01). Subjects with scores of 24-25 had higher plasma tHcy concentrations (14.5 mu mol/L; 13.5-15.6 mu mol/L) than did subjects with scores of 26-28 (P < 0.01) or > 28 (P < 0.001). The risk of hyperhomocysteinemia (plasma tHcy > 15 mumol/L) was higher in subjects with scores of 24-25 (odds ratio: 3.81; 95% CI: 1.9, 7.5) or 26-28 (odds ratio: 1.96; 95% CI: 1.3, 3.0) than in those with scores > 28. The results did not change after adjustment for conventional vascular risk factors and for age, medical, dietary, and lifestyle determinants of plasma tHcy.Conclusion: Elevated plasma tHcy has an independent, graded association with concurrent cognitive impairment as measured with the MMSE in healthy elderly community dwellers.