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
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
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DOI：
10.1016/j.amjmed.2004.08.019
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发表时间：
2005-02-01
影响因子：
5.9
通讯作者：
Seeman, TE
中科院分区：
文献类型：
--
作者：
Kado, DM;Karlamangla, AS;Seeman, TE
背景：血浆总同型半胱氨酸浓度升高可能是认知功能减退和阿尔茨海默病的危险因素，但来自前瞻性研究的数据有限。此外，高同型半胱氨酸水平与低维生素状态相关，目前尚不清楚是同型半胱氨酸毒性还是维生素缺乏导致了观察到的认知功能障碍。方法：我们对499名70至79岁的高功能社区居民进行了横断面和纵向分析，以确定同型半胱氨酸和相关维生素血浆浓度对认知功能和认知功能下降的影响。测定非空腹血浆同型半胱氨酸、叶酸、维生素B-6和维生素B-12的浓度。结果：在对每个变量进行的横断面分析中，同型半胱氨酸水平升高、叶酸或维生素B-6水平低的受试者表现出更差的基线认知功能。在纵向分析中，在调整了包括同型半胱氨酸在内的多个协变量后，叶酸水平最低的四分位数处于7年认知功能下降最差四分位数的风险增加了1.6倍(95%可信区间：1.01至2.31；P=0.04)。随着同型半胱氨酸水平的升高，低叶酸水平在很大程度上解释了认知能力下降的趋势。结论：在高功能老年人中，低叶酸水平似乎是认知能力下降的危险因素。通过饮食中的叶酸摄入，可能会降低认知能力下降的风险。(C)2005 Elsevier Inc.保留所有权利。
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 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. (C) 2005 Elsevier Inc. All rights reserved.