Homocysteine & Dementia (2002)
This study investigated homocysteine & dementia. A total of 1092 subjects without dementia (667 women and 425 men; average age, 76 years) were followed for an average of 8 years. Their homocysteine levels were monitored. The study used multivariable proportional-hazards regression to adjust for age, sex, apolipoprotein E genotype, vascular risk factors other than homocysteine, and plasma levels of folate and vitamins B12 and B6. Over a median follow-up period of eight years, dementia developed in 111 subjects, including 83 given a diagnosis of Alzheimer’s disease. The multivariable-adjusted relative risk of dementia was 1.4 (95 percent confidence interval, 1.1 to 1.9) for each increase of 1 SD in the log-transformed homocysteine value either at base line or eight years earlier. The relative risk of Alzheimer’s disease was 1.8 (95 percent confidence interval, 1.3 to 2.5) per increase of 1 SD at base line and 1.6 (95 percent confidence interval, 1.2 to 2.1) per increase of 1 SD eight years before base line. With a plasma homocysteine level greater than 14 micromol per liter, the risk of Alzheimer’s disease nearly doubled.
Conclusions: An increased plasma homocysteine level is a strong, independent risk factor for the development of dementia and Alzheimer’s disease.
Seshadri S et al, Plasma homocysteine as a risk factor for dementia and Alzheimer’s disease.N Engl J Med., 346(7):476-83, 2002