Total homocysteine and cognitive decline in a community-based sample of elderly subjects - The Rotterdam Study
Total homocysteine and cognitive decline in a community-based sample of elderly subjects - The Rotterdam Study
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DOI：
10.1093/oxfordjournals.aje.a010000
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发表时间：
1999-08-01
影响因子：
5
通讯作者：
Breteler, MMB
中科院分区：
文献类型：
--
作者：
Kalmijn, S;Launer, LJ;Breteler, MMB
同型半胱氨酸与心血管疾病风险增加有关。心血管疾病一直与认知能力下降有关。作者在1990-1994年鹿特丹前瞻性研究中随机抽取了702名55岁或以上的社区居民受访者，调查了同型半胱氨酸与并发认知障碍和随后认知能力下降的关系。用多元Logistic回归计算总同型半胱氨酸水平与认知损害(MMSE评分1分/年)之间的优势比和95%可信区间。平均随访时间为2.7年。在调整了年龄、性别和教育程度后，总同型半胱氨酸水平与认知损害(最高与最低三分位数：优势比(OR)=1.30，95%可信区间(CI)：0.50，3.38)或认知功能下降(中等与最低三分位数，OR=1.14，95%CI：0.67，1.93)无关；最高与最低三分位数：OR=0.91，95%CI：0.52，1.58)，因死亡或无反应而失去随访的受试者在基线时年龄调整后的同型半胱氨酸水平略高，MMSE评分较低。敏感度分析显示，选择性失访并不是参与者中缺乏关联性的可能解释。尽管同型半胱氨酸和认知功能降低之间的关系在生物学上是可信的，但这项研究表明，在社区老年人样本中没有这种联系。
Homocysteine has been associated with an increased risk of cardiovascular disease. Cardiovascular diseases have been related to cognitive decline. The authors investigated the association of homocysteine with concurrent cognitive impairment and subsequent cognitive decline in a random sample of 702 community-dwelling respondents aged 55 years or over to the prospective Rotterdam Study in 1990-1994. Multiple logistic regression was used to calculate odds ratios and 95 percent confidence intervals for the association between total homocysteine levels and cognitive impairment (Mini-Mental State Examination (MMSE) score 1 point/year). Mean duration of follow-up was 2.7 years. After adjustment for age, sex, and education, there was no relation between total homocysteine and cognitive impairment (highest vs. lowest tertile: odds ratio (OR) = 1.30, 95% confidence interval (CI): 0.50, 3.38) or cognitive decline (middle vs. lowest tertile, OR = 1.14, 95% CI: 0.67, 1.93; highest vs. lowest tertile: OR = 0.91, 95% CI: 0.52, 1.58), Subjects who were lost to follow-up due to death or nonresponse had slightly higher age-adjusted homocysteine levels and lower MMSE scores at baseline. Sensitivity analyses showed that selective loss to follow-up was not a likely explanation for the absence of an association in the participants. Although a relation between homocysteine and reduced cognitive function is biologically plausible, this study suggests no such association in a community-based sample of the elderly.