Background: The prevalence and incidence of dementia increase dramatically with age. Cognitive impairment is one major symptom of dementia. Older persons increase in our society, which means a big number of people with decreased cognitive function. So it is important to find out risk factors. The amino acid homocysteine may be a risk factor. Objective: The aim was to determine the independent association of homocysteine and cognitive performance in Thai elderly. Design: Concentrations of homocysteine were measured in fasting blood samples of 100 Thais aged 60 - 80 years. Global cognitive function was assessed by using with mini-Mental State Examination score (MMSE), and cognitive functions were assessed by a neuropsychological test battery. The relationship between homocysteine levels and neuropsychological test scores was assessed by multiple linear regression. Results: In the crude model, homocysteine was inversely associated with scores for learning slope test (B = ?0.048, p = 0.042) and verbal pair total test (B = ?0.124, p = 0.032). After adjusting for confounders, no association was found between homocysteine and cognitive impairment. Age (B = ?0.129, p = 0.007) was found to be a significant determinant of decreased learning slope score. Similarly, age (B = ?0.298, p = 0.009) and education (B = 0.267, p = 0.029) were found to be significant determinants of decreased verbal pair total score. Conclusions: In this study, it was found that no association between homocysteine and cognitive impairment in a population of institutionalized subjects. Age and education were more significantly associated with cognitive impairment scores than homocysteine.
Senanarong, V., Jamjumrus, P., Harnphadungkit, K., Vannasaeng S., Udompunthurak, S., Prayoonwiwat, N. and Poungvarin, N. (2001) Risk Factors for Dementia and Impaired Cognitive Status in Thai Elderly. Journal of Medical Association of Thailand, 84, 468-474.
Budge, M.M., de jager C., Hogervorst, E. and Smith, A.D. (2002) Total Plasma Homocysteine, Age, Systolicblood Pressure, and Cognitive Performance in Older People. Journal of the American Geriatrics Society, 50, 2014-2018.
Duthie, S.J., Whalley, L.J., Collins, A.R., Leaper, S., Gerger, K. and Deary, I.J. (2003) Homocysteine, B Vitamin Status, and Cognitive Function in the Elderly [Published Erratum in The American Journal of Clinical Nutrition, 77, 523]. The American Journal of Clinical Nutrition, 75, 908-913.
Miller, J.W., Green, R., Ramos, M.I., Allen, L.H., Mungas, D.M. and Jagust, W.J. (2003) Homocysteine and Cognitive Function in the Sacramento Area Latino Study on Aging. The American Journal of Clinical Nutrition, 78, 441-447.
Ravaglia, G., Forti, P.L., Maioli, F., Muscari, A., Sacchetti, L. and Arnon, G. (2003) Homocysteine and Cognitive Function in Healthy Elderly Community Dwellers in Italy. The American Journal of Clinical Nutrition, 77, 668-673.
Garcia, A., Haron, Y., Evan, L., Smith, M., Freedman, M. and Roman, G. (2004) Metabolic markers of Cobalamin Deficiency and Cognitive Function in Normal Older Adults. Journal of the American Geriatrics Society, 52, 66-71.
Dufouil, C., Alperovitch, A., Ducros, V. and Tzourio, C. (2003) Homocysteine, White Matter Hyperintensities , and Cognition in Healthy Elderly People. Annals of Neurology, 53, 214-221. http://dx.doi.org/10.1002/ana.10440
Kalmijn, S., Laune,r L.J., Lindemans, J., Bots, M.L., Hojman, A. and Brereler, M.M. (1999) Total Homocysteine and Cognitive Decline in a Community-Based Sample of Elderly Subjects. The Rotterdam Study. American Journal of Epidemiology, 150, 283-289.
Ravaglia, G., Forti, P., Maioli, F., Zanardi, V., Delmonte, E. and Grossi, G. (2000) Blood Homocysteine and Vitamin B Levels Are Not Associated with Cognitive Skills in Healthy Normally Aging Subjects. The Journal of Nutrition, Health and Aging, 4, 218-222.
Goldbohm, R.A., van den Brandt, P.A., Brants, H.A., van’t Veer, P., Ai, M., Sturman, F. and Hermus R.J. (1994) Validation of a Dietary Questionnaire Used in a Large-Scale Prospective Cohort Study on Diet and Cancer. European Journal of Clinical Nutrition, 48, 253-265.
Boushey, C.J., Beresford, S.A., Omenn, G.S. and Motulsky, A.G. (1995) A Quantitative Assessment of Plasma Homocysteine as a Risk Factor of Vascular Disease. Probable Benefits of Increasing Folic Acid Intakes. JAMA, 274, 1049-1057.
Breteler, M.M.B., Claus, J.J., Grobbee, D.E. and Hofman, A. (1994) Cardiovascular Disease and Distribution of Cognitive Function in Elderly People: The Rotterdam Study. BMJ, 308, 1604-1608. http://dx.doi.org/10.1136/bmj.308.6944.1604
Hofman, A., Ott, A., Breteler M.M., Bots, M.L., Slooter, A.J., van Harskamp, F., van Dujin, C.N., van Broeckhoven, C. and Grobbee, D.E. (1997) Artherosclerosis, Apolipoprotein E, and the Prevalence of Dementia and Alzheimer’s Disease in the Rotterdam Study. The Lancet, 349, 151-154. http://dx.doi.org/10.1016/S0140-6736(96)09328-2
Tatemichi, T.K., Deamond, D.W., Stern, Y., Paik, M., Sano, M. and Bagiella, E. (1994) Cognitive Impairment after Stroke: Frequency, Patterns, and Relationship to Functional Abilities. Journal of Neurology, Neurosurgery, and Psychiatry, 57, 202-207.
Tombaugh, T.N. and McIntyre, N.J. (1992) The Mini-Mental State Examination: A Comprehensive Review. Journal of the American Geriatrics Society, 40, 922-935.
Seshadri, S., Beiser, A., Selhub, J., Jacques, P.F., Rosenberg, I.H. and D’Agostino, R.B. (2002) Plasma Homocysteine as a Risk Factor for Dementia and Alzheimer’s Disease. The New England Journal of Medicine, 346, 476-483. http://dx.doi.org/10.1056/NEJMoa011613
Vogel, T., Dali-Youcef, N., Kaltenbach, G. and Andres, E. (2009) Homocysteine, Vitamine B12, Folate and Cognitive Functions: A Systemic and Critical Review of the Literature. International Journal of Clinical Practice, 63, 1061-1067.
Feng, L., Tze-Pin, Ng., Chuah, L., Niti, M. and Ee-Heok, K. (2006) Homocysteine, Folate, and Vitamin B-12 and Cognitive Performance in Older Chinese Adults: Findings from the Singapore Longitudinal Ageing Study. The American Journal of Clinical Nutrition, 84, 1506-1512.
Mooijaart, S.P., Gussekloo, J., Frolich, M., Jolles, J., Stott, D.J., Westendrop, R.G. and de Craen, A.J. (2005) Homocysteine, Vitamin B-12, and Folic Acid and the Risk of Cognitive Decline in Old Age: The Leiden 85-Plus Study. The American Journal of Clinical Nutrition, 82, 866-871.