Hyperhomocysteinemia associated with poor recall in the third National Health and Nutrition Examination Survey.
BACKGROUND
High circulating total homocysteine (tHcy) concentrations are associated with stroke, which is a major cause of cognitive dysfunction. Blood homocysteine concentrations are inversely correlated with performance on some cognitive-function tests and a relation was recently shown between hyperhomocysteinemia and Alzheimer disease.


OBJECTIVE
The objective was to evaluate the relation between serum tHcy concentrations and performance on short delayed-recall tests of elderly men and women participating in the third National Health and Nutrition Examination Survey, phase 2 (1991--1994).


METHODS
Subjects were aged > or =60 y. Subjects reported no previous stroke, completed > or =8 y of education, and took a test of delayed recall of story ideas (n = 1200) or words (n = 1270).


RESULTS
After adjustment for sex, age, race-ethnicity, income, years of education, and serum creatinine concentration, subjects in the upper half of the folate distribution recalled, on average, >4 of 6 story ideas; subjects with lower folate status recalled significantly fewer ideas (P < 0.001). Of the subjects with low folate status, story recall was significantly poorer in those with serum tHcy concentrations above the 80th percentile of the distribution (13.7 micromol/L) than in those with lower tHcy concentrations (P < 0.03). The odds ratio relating hyperhomocysteinemia to recall of > or =1 of 3 previously learned words was 0.3 (95% CI: 0.2, 0.7) after adjustment for the 5 demographic factors alone and was 0.4 (0.2, 0.9) after further adjustment for serum folate concentration.


CONCLUSIONS
Hyperhomocysteinemia is related to poor recall and this association was partially independent of folate status.
Morris
M S
MS
Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA. morris@hnrc.tufts.edu
Jacques
P F
PF
Rosenberg
I H
IH
Selhub
J
J
D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D004912:Erythrocytes / Q000737:chemistry; D005006:Ethnicity; D005260:Female; D006306:Health Surveys; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000523:psychology*; D006973:Hypertension; D008297:Male; D008570:Memory, Short-Term; D008609:Mental Status Schedule; D008875:Middle Aged; D015999:Multivariate Analysis; D044469:Racial Groups; D012737:Sex Factors; D012907:Smoking; D012959:Socioeconomic Factors; D014481:United States
D006710:Homocysteine