Department of Clinical Nutrition, Graduated School of Health Sciences, Dongduk Women's University, 60, Hwarang-ro 13-gil, Seongbuk-gu, Seoul, 02748, Republic of Korea.
Department of Preventive Medicine, College of Medicine, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
Eur J Nutr. 2019 Feb;58(1):399-408. doi: 10.1007/s00394-017-1604-y. Epub 2018 Jan 10.
The aim of this study was to examine the associations between the risk of cognitive impairment and the serum levels of folate, vitamin B, and homocysteine (Hcy).
Subjects were persons aged 60-79 years who participated in the Yangpyeong Cohort study between 2011 and 2012. Cognitive impairment and normal subjects consisted of 100 pairs of old adults matched by age, sex, and education levels. Cognitive function was evaluated with the Korean version of the Mini-Mental State Examination for Dementia Screening (MMSE-DS). Pearson's partial correlation coefficients and conditional multiple logistic regression analysis were applied to determine the associations between cognitive function and the serum levels of folate, vitamin B, and Hcy.
Compared with the matched normal group, the cognitive impairment group had higher proportions of folate deficiency (< 3 ng/mL) and hyperhomocysteinemia (≥ 15 µmol/L). Serum Hcy concentrations were inversely associated with serum folate (r = - 0.234, p = 0.001) and MMSE-DS score (r = - 0.150, p = 0.037) after adjusting for age, sex, and education. The high Hcy group showed a higher prevalence of cognitive impairment (4th vs. 1st quartile, OR 3.30, 95% CI 1.12-9.72, p for trend = 0.014) after adjusting for exercise.
The present findings suggest a putative protective role of high serum folate and normal Hcy against cognitive impairment among older adults.
本研究旨在探讨叶酸、维生素 B 和同型半胱氨酸（Hcy）血清水平与认知障碍风险之间的关联。
本研究对象为年龄在 60-79 岁之间的参加 2011 年至 2012 年杨平队列研究的人群。认知障碍组和正常组由 100 对年龄、性别和教育程度相匹配的老年人组成。认知功能采用韩国版简易精神状态检查（MMSE-DS）进行评估。采用 Pearson 偏相关系数和条件多因素 logistic 回归分析来确定叶酸、维生素 B 和 Hcy 血清水平与认知功能之间的关系。
与匹配的正常组相比，认知障碍组叶酸缺乏（<3ng/mL）和高同型半胱氨酸血症（≥15µmol/L）的比例更高。在校正年龄、性别和教育程度后，血清 Hcy 浓度与血清叶酸（r=-0.234，p=0.001）和 MMSE-DS 评分（r=-0.150，p=0.037）呈负相关。在校正运动后，高 Hcy 组认知障碍的患病率更高（第 4 四分位与第 1 四分位相比，OR 3.30，95%CI 1.12-9.72，p 趋势=0.014）。
本研究结果表明，高血清叶酸和正常 Hcy 可能对老年人的认知障碍具有保护作用。
