Homocysteine and cognitive impairment. Relation with diagnosis and neuropsychological performance.
OBJECTIVE
Elevated total plasma homocysteine (tHcy) is a risk factor for cardiovascular and cerebrovascular disease, and it has also been proposed as an independent risk factor for dementia and Alzheimer's disease (AD). Its relationship with cognitive impairment, however, remains unclear. We aimed to determine the relationship of tHcy levels with clinical diagnoses and cognitive performance in a sample of outpatients with cognitive impairment.


METHODS
Plasma tHcy, folate, vitamin B12 and creatinine levels were assessed in individuals evaluated at the Memory Disorder Unit. Diagnoses included subjective memory complaints (SMC, n = 27), mild cognitive impairment (MCI, n = 142), AD (n = 139) and vascular dementia (VD, n = 17). All patients underwent extensive neuropsychological testing to evaluate attention, memory, language, and visuoconstructional and executive functions, as well as depression and impairments of daily living activities.


RESULTS
tHcy levels did not differ between patients with SMC, MCI, AD or VD. Increased tHcy was associated with worse performance in geometric figure copy and clock drawing tests.


CONCLUSIONS
tHcy levels did not discriminate between diagnostic groups of patients with cognitive impairments. Elevated tHcy levels in these patients appear to have a detrimental effect on visuoconstructional performance.
Sala
Isabel
I
Memory Disorders Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Belén Sánchez-Saudinós
María
M
Molina-Porcel
Laura
L
Lázaro
Estela
E
Gich
Ignasi
I
Clarimón
Jordi
J
Blanco-Vaca
Francisco
F
Blesa
Rafael
R
Gómez-Isla
Teresa
T
Lleó
Alberto
A
D000203:Activities of Daily Living; D000368:Aged; D015415:Biomarkers; D003072:Cognition Disorders / Q000097:blood* / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology*; D012044:Regression Analysis; D012307:Risk Factors
D015415:Biomarkers; D006710:Homocysteine