High circulating levels of homocysteine, especially with increasing age, have been associated with cognitive impairment. In recent studies, Alzheimer disease and dementia after multiple strokes have been linked to extremely high serum homocysteine concentrations. Research published in the American Journal of Clinical Nutrition by Morris et al. assessed the relationship between homocysteine levels and short-term memory recall in a group of older subjects and found an independent relationship between very high homocysteine levels and poor performance on cognitive tests.
As part of the larger third National Health and Nutrition Examination Survey (NHANES III), 1299 men and women aged 60 and over, none of who had previously had a stroke, participated in the study between 1991 and 1994. The median age of the participants was 70 years, 42% were men, and 89% were non-Hispanic whites. The subjects' serum concentrations of nutrients, cholesterol, folate and homocysteine were measured. Factors of gender, age, years of education, income and ethnicity were controlled for in assessment of the data.
The folate status of the participants was an important consideration because folate has been shown to significantly modify homocysteine levels. Story recall was worse among subjects with a combination of low folate and high homocysteine than in those whose homocysteine levels were normal or low. Homocysteine levels increased with age and were accompanied by a comparable decline in folate status. The researchers found independent associations between the highest levels of homocysteine and poorer recall. Among subjects in the highest quintile of serum homocysteine (>13.7 mmol/L), the odds of passing a word delayed-recall test were identical whether their folate status was high or low.
Morris, Martha S., et al. Hyperhomocysteinemia associated with poor recall in the third National Health and Nutrition Examination Survey. Am J Clin Nutr 2001;73:927-933.
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