title: Plasma homocysteine, but not folate or vitamin B-12, predicts mortality in older people in the United Kingdom.
abstract: There is uncertainty about the importance of plasma levels of homocysteine, vitamin B-12, and folate for all-cause and cardiovascular disease (CVD) mortality in older people. We examined the associations between plasma levels of folate, vitamin B-12, and homocysteine, and all-cause and CVD mortality among community-dwelling adults aged > or = 75 y living in the United Kingdom. In a population-based prospective cohort study, 853 men and women aged > or = 75 y were examined in 1995-98 as part of the Medical Research Council Trial of Assessment and Management of Older People in the Community. During a median follow-up of 7.6 y (5528 person-years of follow-up), 429 individuals (50.3%) died, including 185 from CVD. Individuals with plasma homocysteine levels in the top one-third compared with the bottom one-third had a 2-fold higher risk of all-cause mortality (hazard ratio, 2.20; 95% CI, 1.76, 2.75; P < 0.001) and CVD mortality (hazard ratio, 1.96; 95% CI, 1.39, 2.78; P < 0.001) after adjustment for age, sex, and other covariates. There was no association of plasma folate or vitamin B-12 levels with mortality. Our results extend previously reported associations of homocysteine with mortality, and the absence of associations of folate and vitamin B-12 with mortality, to the older population.
authors.affiliation: Centre for Ageing and Public Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. alan.dangour@lshtm.ac.uk
authors.forename: Alan D
authors.initials: AD
authors.lastname: Dangour
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Breeze
authors.forename: Robert
authors.initials: R
authors.lastname: Clarke
authors.forename: Prakash S
authors.initials: PS
authors.lastname: Shetty
authors.forename: Ricardo
authors.initials: R
authors.lastname: Uauy
authors.forename: Astrid E
authors.initials: AE
authors.lastname: Fletcher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002318:Cardiovascular Diseases / Q000097:blood / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12