Garcia Angeles, Haron Yafa, Pulman Kate, Hua Lien, Freedman Morris
Department of Medicine, Division of Geriatrics, Queen's University, Kingston, Ontario, Canada K7L 5A2.
J Gerontol A Biol Sci Med Sci. 2004 Dec;59(12):1323-7. doi: 10.1093/gerona/59.12.1323.
Elevated blood levels of homocysteine have been associated with cerebrovascular disease and cognitive impairment. The authors' objective was to determine the relationship between cognitive changes and variations in tHcy levels over time in healthy elderly volunteers.
This prospective cohort study was conducted in healthy community-dwelling older adults without cerebrovascular disease at baseline and followed them for 2.3 years. Cobalamin, red blood cell folate, total serum homocysteine (tHcy), and creatinine levels were measured and recorded. Cognitive measures included the Mini Mental State Examination, California Verbal Learning Test, Mattis Dementia Rating Scale, and Stroop Neuropsychological Inventory.
At baseline, participants with elevated tHcy levels had lower Stroop scores (72.7 vs 85.35, p <.05) than did participants with normal tHcy levels. The tHcy levels correlated significantly with Stroop scores at baseline and follow-up. At follow-up, tHcy levels had increased in 104 participants (group I) and decreased in 76 participants (group II). Compared to mean baseline values, the mean tHcy in both groups had changed significantly at follow-up (p <.05 and p <.001, respectively). Participants in group I had significantly lower Stroop scores in multivariate analyses at follow-up than at baseline. The scores of participants in group II at follow-up were not significantly different than their scores at baseline. The rate of change of tHcy levels and the rate of change of the Stroop scores were significantly correlated (r = -0.264, p <.001) after multivariate analysis. Stroop scores decreased by 22% at follow-up in participants whose tHcy levels increased by 40% from baseline to follow-up.
Elevated tHcy levels and increases in tHcy during a short period of time are associated with decreased Stroop scores in otherwise cognitively normal elderly volunteers.
血液中同型半胱氨酸水平升高与脑血管疾病和认知障碍有关。作者的目的是确定健康老年志愿者认知变化与总同型半胱氨酸（tHcy）水平随时间变化之间的关系。
这项前瞻性队列研究在基线时无脑血管疾病的健康社区老年人中进行，并对他们进行了2.3年的随访。测量并记录了钴胺素、红细胞叶酸、总血清同型半胱氨酸（tHcy）和肌酐水平。认知测量包括简易精神状态检查、加利福尼亚言语学习测试、马蒂斯痴呆评定量表和斯特鲁普神经心理量表。
在基线时，tHcy水平升高的参与者的斯特鲁普得分（72.7对85.35，p<.05）低于tHcy水平正常的参与者。tHcy水平在基线和随访时与斯特鲁普得分显著相关。在随访时，104名参与者（第一组）的tHcy水平升高，76名参与者（第二组）的tHcy水平降低。与平均基线值相比，两组的平均tHcy在随访时均有显著变化（分别为p<.05和p<.001）。在多变量分析中，第一组参与者在随访时的斯特鲁普得分显著低于基线时。第二组参与者在随访时的得分与基线时无显著差异。多变量分析后，tHcy水平的变化率与斯特鲁普得分的变化率显著相关（r=-0.264，p<.001）。从基线到随访tHcy水平升高40%的参与者在随访时斯特鲁普得分下降了22%。
在认知功能正常的老年志愿者中，tHcy水平升高以及短期内tHcy升高与斯特鲁普得分降低有关。
