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Increased Total Homocysteine Levels Predict the Risk of Incident Dementia Independent of Cerebral Small-Vessel Diseases and Vascular Risk Factors.
- Source :
-
Journal of Alzheimer's Disease . 2016, Vol. 49 Issue 2, p503-513. 11p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Homocysteine has been identified as a potential risk factor for stroke, cerebral small-vessel diseases (SVD), and dementia.<bold>Objective: </bold>The present study aimed to investigate the predictive value of homocysteine levels on incident dementia while simultaneously controlling for MRI findings and vascular risk factors.<bold>Methods: </bold>Within a Japanese cohort of participants with vascular risk factors in an observational study, we evaluated the association between baseline total homocysteine (tHcy) levels (per 1 μmol/L and the tertile of tHcy), the prevalence of MRI-findings at baseline, and incident all-cause dementia. Baseline brain MRI was used to determine SVD (lacunas, white matter hyperintensities, and cerebral microbleeds [CMBs]) and atrophy (medial-temporal lobe atrophy and bicaudate ratio). Logistic regression analyses were used to estimate the cross-sectional association between tHcy and each of MRI findings. Cox proportional hazards analyses were performed to estimate the longitudinal association between tHcy and dementia.<bold>Results: </bold>In the 643 subjects (age: 67.2 ± 8.4 years, male: 59% ; education: 12.9 ± 2.6 years), multivariable analyses adjusted for several potential confounders, including estimated glomerular filtration rate (eGFR) and intima-media thickness, showed that highest tHcy tertile was associated with lacunas, CMBs, and strictly deep CMBs. During the mean 7.3-year follow-up (range: 2-13), 47 patients were diagnosed with dementia (Alzheimer's disease: 24; vascular dementia: 18; mixed-type: 3; other: 2). After adjusting for age, gender, APOE ɛ4, education, BMI, MMSE, hypertension, cerebrovascular events, eGFR, and MRI-findings, tHcy level (hazard ratios [HR]: 1.08, p = 0.043) and the highest tertile of tHcy (HR: 2.50, p = 0.047) for all-cause dementia remained significant.<bold>Conclusions: </bold>Our results provide additional evidence of tHcy that contributes to increased susceptibility to dementia risk. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HOMOCYSTEINE in the body
*DEMENTIA risk factors
*CEREBRAL small vessel diseases
*VASCULAR diseases
*GLOMERULAR filtration rate
*ALZHEIMER'S disease
*DISEASE risk factors
*DEMENTIA
*LONGITUDINAL method
*MAGNETIC resonance imaging
*NEUROPSYCHOLOGICAL tests
*NONPARAMETRIC statistics
*PSYCHOLOGICAL tests
*QUESTIONNAIRES
*HOMOCYSTEINE
*PREDICTIVE tests
*DISEASE incidence
*PROPORTIONAL hazards models
*CAROTID intima-media thickness
Subjects
Details
- Language :
- English
- ISSN :
- 13872877
- Volume :
- 49
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Journal of Alzheimer's Disease
- Publication Type :
- Academic Journal
- Accession number :
- 111229396
- Full Text :
- https://doi.org/10.3233/JAD-150458