Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK.
Int Psychogeriatr. 2011 Dec;23(10):1607-15. doi: 10.1017/S1041610211000779. Epub 2011 May 6.
Elevated plasma homocysteine concentrations have been associated with both cognitive impairment and dementia. However, it is unclear whether some cognitive domains are more affected than others, or if this relationship is independent of B12 and folate levels, which can also affect cognition. We examined the relationship between plasma homocysteine and cognitive decline in an older hypertensive population.
182 older people (mean age 80 years) with hypertension and without dementia, were studied at one center participating in the Study on COgnition and Prognosis in the Elderly (SCOPE). Annual cognitive assessments were performed using a computerized assessment battery and executive function tests, over a 3-5 year period (mean 44 months). Individual rates of decline on five cognitive domains were calculated for each patient. End of study plasma homocysteine, folate and B12 concentrations were measured. The relationship between homocysteine levels and cognitive decline was studied using multivariate regression models, and by comparing high versus low homocysteine quartile groups.
Higher homocysteine showed an independent association with greater cognitive decline in three domains: speed of cognition (β = -27.33, p = 0.001), episodic memory (β = -1.25, p = 0.02) and executive function (β = -0.05, p = 0.04). The association with executive function was no longer significant after inclusion of folate in the regression model (β = -0.032, p = 0.22). Change in working memory and attention were not associated with plasma homocysteine, folate or B12. High homocysteine was associated with greater decline with a Cohen's d effect size of approximately 0.7 compared to low homocysteine.
In a population of older hypertensive patients, higher plasma homocysteine was associated with cognitive decline.
血浆同型半胱氨酸浓度升高与认知障碍和痴呆有关。然而，目前尚不清楚是否某些认知领域比其他领域更容易受到影响，或者这种关系是否独立于同样会影响认知的 B12 和叶酸水平。我们在一个老年高血压人群中研究了血浆同型半胱氨酸与认知能力下降之间的关系。
在参与认知和预后研究的中心（SCOPE），对 182 名年龄在 80 岁以上、无痴呆的高血压老年人进行了研究。在 3-5 年（平均 44 个月）的时间里，使用计算机评估工具和执行功能测试进行年度认知评估。为每位患者计算五个认知领域的个体下降率。在研究结束时测量血浆同型半胱氨酸、叶酸和 B12 浓度。使用多元回归模型和比较高与低同型半胱氨酸四分位数组来研究同型半胱氨酸水平与认知下降之间的关系。
更高的同型半胱氨酸与三个认知领域的认知下降有独立的关联：认知速度（β=-27.33，p=0.001）、情景记忆（β=-1.25，p=0.02）和执行功能（β=-0.05，p=0.04）。在回归模型中纳入叶酸后，与执行功能的关联不再显著（β=-0.032，p=0.22）。工作记忆和注意力的变化与血浆同型半胱氨酸、叶酸或 B12 无关。与低同型半胱氨酸相比，高同型半胱氨酸与更大的下降相关，其 Cohen's d 效应大小约为 0.7。
在老年高血压患者人群中，较高的血浆同型半胱氨酸与认知下降有关。
