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Homocysteine levels and dementia risk in Yoruba and African Americans

Published online by Cambridge University Press:  30 July 2013

Hugh C. Hendrie ,
Olusegun Baiyewu ,
Kathleen A. Lane ,
Christianna Purnell ,
Sujuan Gao ,
Ann Hake ,
Adesola Ogunniyi ,
Oye Gureje ,
Frederick W. Unverzagt  and
Jill Murrell
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Hugh C. Hendrie*
Affiliation:
Indiana University Center for Aging Research, Indianapolis, Indiana, USA Regenstrief Institute Inc., Indianapolis, Indiana, USA Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
Olusegun Baiyewu
Affiliation:
Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria
Kathleen A. Lane
Affiliation:
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
Christianna Purnell
Affiliation:
Regenstrief Institute Inc., Indianapolis, Indiana, USA
Sujuan Gao
Affiliation:
Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
Ann Hake
Affiliation:
Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
Adesola Ogunniyi
Affiliation:
Department of Medicine, College of Medicine, University of Ibadan, Nigeria
Oye Gureje
Affiliation:
Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria
Frederick W. Unverzagt
Affiliation:
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
Jill Murrell
Affiliation:
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
Mark A. Deeg
Affiliation:
Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA
Kathleen Hall
Affiliation:
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
*
Correspondence should be addressed to: Hugh C. Hendrie, MB, ChB, DSc, Indiana University Center for Aging Research, 410 W 10th St., Suite 2000 Indianapolis, IN 46202, USA. Phone: +(317)-423-5591; Fax: +(317)-423-5695. Email: [email protected].
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Abstract

Background:

High levels of homocysteine have been associated with increased risk for dementia although results have been inconsistent. There are no reported studies from the developing world including Africa.

Methods:

In this longitudinal study of two community-dwelling cohorts of elderly Yoruba and African Americans, levels of homocysteine, vitamin B12 and folate were measured from blood samples taken in 2001. These levels were compared in two groups, participants who developed incident dementia in the follow-up until 2009 (59 Yoruba and 101 African Americans) and participants who were diagnosed as cognitively normal or in the good performance category at their last follow-up (760 Yoruba and 811 African Americans). Homocysteine levels were divided into quartiles for each site.

Results:

After adjusting for age, education, possession of ApoE, smoking, and time of enrollment the higher quartiles of homocysteine were associated with a non-significant increase in dementia risk in the Yoruba (homocysteine quartile 4 vs. 1 OR: 2.19, 95% CI 0.95–5.07, p = 0.066). For the African Americans, there was a similar but non-significant relationship between higher homocysteine levels and dementia risk. There were no significant relationships between levels of vitamin B12 and folate and incident dementia in either site although folate levels were lower and vitamin B12 levers were higher in the Yoruba than in the African Americans.

Conclusions:

Increased homocysteine levels were associated with a similar but non-significant increase in dementia risk for both Yoruba and African Americans despite significant differences in folate levels between the two sites.

Keywords

dementiaAlzheimer’s diseasehomocysteineAfrican AmericansYoruba
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 11 , November 2013 , pp. 1859 - 1866
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

American Psychiatric Association. (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., Rev. Washington, DC: American Psychiatric Assocation.Google Scholar
American Psychiatric Association Press. (1992). ICD-10. The International Statistical Classification of Diseases and Related Health Problems: 1 and 2. Washington, DC: American Psychiatric Association Press.Google Scholar
Baiyewu, O.et al. (2002). Cognitive impairment in community-dwelling older Nigerians: clinical correlates and stability of diagnosis. European Journal of Neurology, 9, 573–580.CrossRefGoogle ScholarPubMed
Barnes, D. E. and Yaffe, K. (2011). The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurology, 10, 819–828.CrossRefGoogle ScholarPubMed
Bates, C. J., Mansoor, M. A., Pentieva, K. D., Hamer, M. and Mishra, G. D. (2010). Biochemical risk indices, including plasma homocysteine, that prospectively predict mortality in older British people: the National Diet and Nutrition Survey of people aged 65 years and over. The British Journal of Nutrition, 104, 893–899.CrossRefGoogle ScholarPubMed
Dangour, A. D.et al. (2010). B-vitamins and fatty acids in the prevention and treatment of Alzheimer's disease and dementia: a systematic review. Journal of Alzheimer's Disease, 22, 205–224.CrossRefGoogle ScholarPubMed
Deeg, M.et al. (2008). A comparison of cardiovascular disease risk factor biomarkers in African Americans and Yoruba Nigerians. Ethnicity & Disease, 18, 427–433.Google ScholarPubMed
Devlin, A. M., Clarke, R., Birks, J., Evans, J. G. and Halsted, C. H. (2006). Interactions among polymorphisms in folate-metabolizing genes and serum total homocysteine concentrations in a healthy elderly population. The American Journal of Clinicial Nutrition, 83, 708–713.CrossRefGoogle Scholar
Ferri, C. P.et al. (2005). Global prevalence of dementia: a Delphi consensus study. Lancet, 366, 2112–2117.CrossRefGoogle ScholarPubMed
Haan, M. N.et al. (2007). Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment: results from the Sacramento Area Latino Study on aging. The American Journal of Clinical Nutrition, 85, 511–517.CrossRefGoogle Scholar
Hackam, D. G. and Anand, S. S. (2003). Emerging risk factors for atherosclerotic vascular disease: a critical review of the evidence. JAMA, 290, 932–940.CrossRefGoogle ScholarPubMed
Hall, K. S., Gao, S., Emsley, C. L., Ogunniyi, A. O., Morgan, O. and Hendrie, H. C. (2000). Community screening interview for dementia (CSI ‘D’); performance in five disparate study sites. International Journal of Geriatric Psychiatry, 15, 521–531.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Hendrie, H. C.et al. (1988). The CAMDEX: a standardized instrument for the diagnosis of mental disorder in the elderly: a replication with a US sample. Journal of the American Geriatrics Society, 36, 402–408.CrossRefGoogle ScholarPubMed
Hendrie, H. C.et al. (2001). Incidence of dementia and Alzheimer disease in 2 communities: Yoruba residing in Ibadan, Nigeria, and African Americans residing in Indianapolis, Indiana. JAMA, 285, 739–747.CrossRefGoogle ScholarPubMed
Hendrie, H. C., Hall, K. S., Ogunniyi, A. and Gao, S. (2004). Alzheimer's disease, genes, and environment: the value of international studies. Canadian Journal of Psychiatry, 49, 92–99.CrossRefGoogle ScholarPubMed
Hendrie, H. C.et al. (2006). The development of a semi-structured home interview (CHIF) to directly assess function in cognitively impaired elderly people in two cultures. International Psychogeriatrics, 18, 653–666.CrossRefGoogle ScholarPubMed
Ho, R. C.et al. (2011). Is high homocysteine level a risk factor for cognitive decline in elderly? A systematic review, meta-analysis, and meta-regression. The American Journal of Geriatric Psychiatry, 19, 607–617.CrossRefGoogle Scholar
Kim, J. M.et al. (2008). Changes in folate, vitamin B12 and homocysteine associated with incident dementia. Journal of Neurology, Neurosurgery, and Psychiatry, 79, 864–868.CrossRefGoogle ScholarPubMed
Kivipelto, M.et al. (2009). Homocysteine and holo-transcobalamin and the risk of dementia and Alzheimers disease: a prospective study. European Journal of Neurology, 16, 808–813.CrossRefGoogle ScholarPubMed
Luchsinger, J. A., Tang, M. X., Shea, S., Miller, J., Green, R. and Mayeux, R. (2004). Plasma homocysteine levels and risk of Alzheimer disease. Neurology, 62, 1972–1976.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Morris, J. C.et al. (1989). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology, 39, 1159–1165.Google Scholar
Olayiwola, I. O., Fadupin, G. T., Agbato, S. O. and Soyewo, D. O. (2012). Serum micronutrient status and nutrient intake of elderly Yoruba people in a slum of Ibadan, Nigeria. Public Health Nutrition, 1–7.Google Scholar
Ozarda, Y., Sucu, D. K., Hizli, B. and Aslan, D. (2009). Rate of T alleles and TT genotype at MTHFR 677C->T locus or C alleles and CC genotype at MTHFR 1298A->C locus among healthy subjects in Turkey: impact on homocysteine and folic acid status and reference intervals. Cell Biochemistry and Function, 27, 568–577.CrossRefGoogle Scholar
Plassman, B. L., Williams, J. W. Jr., Burke, J. R., Holsinger, T. and Benjamin, S. (2010). Systematic review: factors associated with risk for and possible prevention of cognitive decline in later life. Annals of Internal Medicine, 153, 182–193.CrossRefGoogle ScholarPubMed
Ravaglia, G.et al. (2008). Mild cognitive impairment: epidemiology and dementia risk in an elderly Italian population. Journal of the American Geriatrics Society, 56, 51–58.CrossRefGoogle Scholar
Seshadri, S.et al. (2002). Plasma homocysteine as a risk factor for dementia and Alzheimer's disease. The New England Journal of Medicine, 346, 476–483.CrossRefGoogle ScholarPubMed
Unverzagt, F. W.et al. (2001). Prevalence of cognitive impairment: data from the Indianapolis Study of Health and Aging. Neurology, 57, 1655–1662.CrossRefGoogle ScholarPubMed
Unverzagt, F. W.et al. (2011). Incidence and risk factors for cognitive impairment no dementia and mild cognitive impairment in African Americans. Alzheimer Disease and Associated Disorders, 25, 4–10.CrossRefGoogle ScholarPubMed
Wald, D. S., Kasturiratne, A. and Simmonds, M. (2011). Serum homocysteine and dementia: meta-analysis of eight cohort studies including 8669 participants. Alzheimers & Dementia, 7, 412–417.CrossRefGoogle ScholarPubMed