Association between subclinical carotid atherosclerosis, hyperhomocysteinaemia and mild cognitive impairment.
OBJECTIVE
Evidence suggests that intima-media thickness (IMT) and plasma homocysteine (Hcy) levels are associated with one another, and both appear to be related to cognitive dysfunction. However, no connection between both factors taken together and mild cognitive impairment (MCI) has been established. This study analysed potential relationships between IMT, Hcy and MCI.


METHODS
We included 105 patients with MCI and 76 controls with no history of vascular disease. All participants underwent laboratory analyses, a carotid ultrasound, and clinical and neuropsychological assessment. We used the Mantel-Haenszel test (MHT), ANCOVA and multiple linear regression models (MLRM) to examine any associations between IMT, Hcy and cognitive state.


RESULTS
The MHT revealed a significant association between IMT and risk of MCI (z = 4.285, P < 0.0001). The OR for the upper quartile vs the lower quartile was 5.12 (95% CI: 2.12-12.36). MHT also showed a clear association between Hcy levels and risk of MCI (z = 3.01, P = 0.003). OR for the upper vs the lower quartile was 3.39 (95% CI: 1.41-8.12). Additionally, we found a correlation between IMT and Hcy (r = 0.162, P = 0.032).


CONCLUSIONS
Our results suggest that there is a connection between IMT, Hcy levels and presence of amnestic MCI in a population with no history of clinically manifest atherosclerosis. Furthermore, there is also a connection between the IMT and Hcy levels themselves.
Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain.|CIBERNED, Department of Biochemistry and Molecular Biology and Genetics, Nursing College, Universidad de Extremadura, Cáceres, Spain.
I
I
Casado-Naranjo
Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain.
R
R
Romero Sevilla
Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain.
J C
JC
Portilla Cuenca
Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain.
B
B
Duque de San Juan
Department of Neurology, Hospital San Pedro de Alcántara, Cáceres, Spain.
M L
ML
Calle Escobar
Department of Immunology, Hospital San Pedro de Alcántara, Cáceres, Spain.
L
L
Fernández Pereira
CIBERNED, Department of Biochemistry and Molecular Biology and Genetics, Nursing College, Universidad de Extremadura, Cáceres, Spain.
J M
JM
Fuentes
Department of Neurology, Hospital Universitario Infanta Cristina, Badajoz, Spain.
J M
JM
Ramírez-Moreno
D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000453:epidemiology* / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male
D006710:Homocysteine
atherosclerosis; homocysteine; intima-media thickness; mild cognitive impairment