From mild cognitive impairment to Alzheimer's disease - influence of homocysteine, vitamin B12 and folate on cognition over time: results from one-year follow-up.
OBJECTIVE
People with mild cognitive impairment (MCI) have higher risk of developing dementia than the general population. Currently known risk factors for dementia include older age, low education level, gait disorders, hippocampal atrophy, and apolipoprotein E allele. Vascular risk factors may modify the neurodegenerative process. The aim of this study was therefore to assess the influence of vascular (genetic and environmental) risk factors on progression to dementia in an MCI group during a one-year period.


METHODS
Fifty-five MCI patients (30 men and 25 women) and 44 controls (25 men and 19 women) matched for age, gender and education were studied. Mild cognitive impairment was diagnosed according to Petersen criteria (Mayo Clinic Group). Neuropsychological evaluation was made. Assessed vascular risk factors included hypertension, cardiovascular disease, diabetes, cigarette smoking, hyperlipidaemia, hyperhomocysteinaemia with vitamin B12 and folate deficiency. Genetic risk factors (APOE polymorphism, C677T and A1298C MTHFR polymorphisms) were also assessed.


RESULTS
Vascular risk factors were found significantly more often in the MCI group (p = 0.041), including APOE4 allele (p = 0.018), hyperhomocysteinaemia (p = 0.012) and folate deficiency (p = 0.023). Discriminant function analysis showed that only age and hypertension are potential factors which may have an influence on progression to dementia in the MCI group within one year of prospective observation.


CONCLUSIONS
Vascular risk factors are associated with cognitive impairment but do not have a significant influence on progression to dementia in the MCI group.
Siuda
Joanna
J
Katedra i Klinika Neurologii, SP Centralny Szpital Kliniczny SUM im. prof. K. Gibińskiego, ul.Medyków 14, 40-752 Katowice. siuda_j@poczta.onet.pl
Gorzkowska
Agnieszka
A
Patalong-Ogiewa
Maja
M
Krzystanek
Ewa
E
Czech
Ewa
E
Wiechuła
Barbara
B
Garczorz
Wojciech
W
Danch
Alojzy
A
Jasińska-Myga
Barbara
B
Opala
Grzegorz
G
D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology*; D001057:Apolipoproteins E / Q000235:genetics; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D015984:Causality; D003072:Cognition Disorders / Q000453:epidemiology* / Q000378:metabolism*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005492:Folic Acid / Q000378:metabolism*; D005500:Follow-Up Studies; D006579:Heterozygote; D006710:Homocysteine / Q000378:metabolism*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000453:epidemiology*; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D011044:Poland / Q000453:epidemiology; D011110:Polymorphism, Genetic; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014805:Vitamin B 12 / Q000378:metabolism; D014806:Vitamin B 12 Deficiency / Q000453:epidemiology*
D001057:Apolipoproteins E; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12