Homocysteine and Cognitive Decline in Healthy ElderlyMcCaddon A.a · Hudson P.b · Davies G.b · Hughes A.c · Williams J.H.H.d · Wilkinson C.a
aUniversity of Wales College of Medicine, Wrexham, bBiochemistry Department, Wrexham Maelor Hospital, Wrexham, cRoyal Alexandra Hospital, Paisley, dBiology Department, Chester College, Chester, UK Corresponding Author
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Serum homocysteine is increased, and correlates inversely with cognitive scores, in Alzheimer’s disease (AD), vascular dementia and ‘age-associated memory impairment’. Elevated levels might signal accelerated cognitive decline, although this remains to be established. We therefore repeated Mini-Mental State Examinations, together with additional ADAS-Cog assessments, in 32 healthy elderly individuals to determine whether prior homocysteine levels predicted cognitive changes over a 5-year period. Homocysteine predicted follow-up cognitive scores and rate of decline in cognitive performance independently of age, sex, education, renal function, vitamin B status, smoking and hypertension (p < 0.001). Homocysteine predicted word recall (p = 0.01), orientation (p = 0.02) and constructional praxis scores (p < 0.0001). One subject, with the second highest initial homocysteine, had developed probable AD at follow-up. Fasting total serum homocysteine appears to be an independent predictor of cognitive decline in healthy elderly and exerts a maximal effect on spatial copying skills.
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