Associations Between Elevated Homocysteine, Cognitive Impairment, and Reduced White Matter Volume in Healthy Old Adults
| Autor: | Tze Pin Ng, Vivian Isaac, K. Ranga Rama Krishnan, Michael W. L. Chee, Sam K. Y. Sim, Lei Feng |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Homocysteine Population Neuropsychological Tests Nerve Fibers Myelinated White matter chemistry.chemical_compound Folic Acid Asian People Internal medicine Diabetes mellitus medicine Humans education Aged Singapore education.field_of_study medicine.diagnostic_test Age Factors Brain Organ Size Middle Aged medicine.disease Magnetic Resonance Imaging Hyperintensity Vitamin B 12 Psychiatry and Mental health Endocrinology Blood pressure medicine.anatomical_structure chemistry Cardiovascular Diseases Linear Models Female Geriatrics and Gerontology Cognition Disorders Lipid profile Psychology Body mass index |
| Zdroj: | The American Journal of Geriatric Psychiatry. 21:164-172 |
| ISSN: | 1064-7481 |
| DOI: | 10.1016/j.jagp.2012.10.017 |
| Popis: | Objectives Elevated homocysteine has emerged as a risk factor for cognitive impairment even in healthy elderly persons. Reduced brain volume and white matter hyperintensities also occur in healthy elderly as well, but the interrelationships between these have not been well studied. We report these interrelationships in non demented, relatively healthy, community-dwelling older adults from a single East Asian population. Methods Two hundred twenty-eight right-handed participants age 55 years and above were evaluated. Persons with medical conditions or neurological diseases other than well-controlled diabetes mellitus and hypertension were excluded. Participants underwent quantitative magnetic resonance imaging of the brain using a standardized protocol and neuropsychological evaluation. Plasma homocysteine, folate, vitamin B 12 , and markers for cardiovascular risk: blood pressure, body mass index, fasting blood glucose, and lipid profile were measured. Results Elevated homocysteine was associated with reduced global cerebral volume, larger ventricles, reduced cerebral white matter volume, and lower cognitive performance in several domains. Elevated homocysteine was associated with reduced white matter volume (β = −20.80, t = −2.9, df = 223, p = 0.004) and lower speed of processing (β = −0.38, t = −2.1, df = 223, p = 0.03), even after controlling for age, gender, and education. However, the association between homocysteine and lower speed of processing disappeared after controlling for white matter volume. Elevated homocysteine was not associated with white matter hyperintensity volume or with hippocampal volume. Although homocysteine and folate levels were correlated, their effects on white matter volume were dissociated. Conclusion In non demented, relatively healthy adults, elevated homocysteine is associated with lower cognitive scores and reduced cerebral white matter volume. These effects can be dissociated from those related to white matter hyperintensities or reduced folate level. |
| Databáze: | OpenAIRE |
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