title: Serum Homocysteine and Folate Levels are Associated With Late-life Dementia in a Korean Population.
abstract: OBJECTIVE
  We aimed to determine whether serum levels of homocysteine (Hcy) and its biological determinants, folate and vitamin B12, are related to cognitive decline in elderly people.
  
  
  METHODS
  The concentrations of total Hcy, folate, and vitamin B12 were measured in serum samples from 424 cognitively normal controls, 382 mild cognitive impairment patients, and 56 dementia patients from Ansan Geriatric cohort. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery was used to evaluate cognitive functions.
  
  
  RESULTS
  The dementia patients had higher serum Hcy (dementia, 17.6 ± 6.9 μmol/L; control, 12.9 ± 5.0 μmol/L; p < 0.001) and lower serum folate (dementia, 7.9 ± 4.8 ng/mL; control, 10.0 ± 7.1 ng/mL; p = 0.034) levels compared with controls. There was an inverse relationship between Hcy levels and serum folate or vitamin B12 concentrations. The cognitive status as measured by the (CERAD) score was inversely related to Hcy levels. The adjusted odds ratio of dementia was 5.18 (95% confidence interval: 1.91-14.10; p = 0.001) for moderate (30 ≥ Hcy > 15) hyperhomocysteinemia compared with normal Hcy levels (≤15 μmol/L). In addition, there was weak association between low serum folate (<3.0 ng/mL) and the risk for dementia (crude odds ratio = 3.68; 95% confidence interval: 1.07-12.69; p = 0.039).
  
  
  CONCLUSIONS
  Elevated serum Hcy and decreased serum folate concentrations are associated with the risk of dementia in Korean elders.
authors.affiliation: Division of Brain Diseases, Department of Biomedical Sciences, National Institute of Health, Korea Centers for Disease Control and Prevention, Seoul, Korea.
authors.forename: Ju Hee
authors.initials: JH
authors.lastname: Song
authors.forename: Moon Ho
authors.initials: MH
authors.lastname: Park
authors.forename: Changsu
authors.initials: C
authors.lastname: Han
authors.forename: Sangmee A
authors.initials: SA
authors.lastname: Jo
authors.forename: Kyungsook
authors.initials: K
authors.lastname: Ahn
keywords: dementia; folate; homocysteine; mild cognitive impairment; vitamin B12