Re: Low Folate >>> Dementia ...... Maybe

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Hi All, The pdf of the paper is availed. Cheers, Al http://news.bbc.co.uk/2/hi/health/7226872.stm Changes in folate, vitamin B12 and homocysteineassociated with incident dementiaJ-M Kim,1 R ,2 S-W Kim,1 I-S Shin,1 S-J Yang,1 H-Y Shin,3 J-S Yoon1,3 ABSTRACT Objectives: Prospective findings have not been consistentfor folate, vitamin B12 and homocysteine concentrationsas predictors of dementia. This study aimed toinvestigate both baseline concentrations of folate, vitaminB12 and homocysteine and changes in these concentrationsas predictors/correlates of incident dementia. Methods: Of 625 elderly patients without dementia atbaseline, 518 (83%) were followed

over a 2.4 year periodand were clinically assessed for incident dementia andAlzheimer’s disease (AD). Serum concentrations of folate,vitamin B12 and homocysteine were measured at thebaseline and follow-up assessments. Covariates includedage, sex, education, disability, depression, alcoholconsumption, physical activity, vascular risk factors,serum creatinine concentration, vitamin intake and weightchange. Results: Only baseline lower folate concentrationspredicted incident dementia. The onset of dementia wassignificantly associated with an exaggerated decline infolate, a weaker increase in vitamin B12 concentrationsand an exaggerated increase in homocysteine concentrationsover the follow-up period. These associationswere reduced following adjustment for weight changeover the same period. Conclusions: Incident dementia is more stronglyassociated with

changes in folate, vitamin B12 andhomocysteine than with previous concentrations. Thesechanges may be linked to other somatic manifestations ofearly dementia, such as weight loss. Table 2 Baseline and changed values for folate, vitamin B12 and homocysteine by incident dementia status.============================================== No incident dementia (n=473) Incident dementia (n=45) p Value*==============================================Baseline valuesFolate (nmol/l) 25.2 (12.8; 7.8,88.4) 21.3 (11.1; 8.5,54.5) 0.018Vitamin B12 (pmol/l) 381.5 (147.7; 104,1334) 372.6 (164.7; 141,983) 0.483Homocysteine (mmol/l) 12.3 (5.2; 1.0,50.0) 14.3 (8.1; 5.4,44.0) 0.146Changed valuesFolate (nmol/l) 24.5 (12.1; 245.8,+43.9) 210.8 (11.2; 237.4,+11.5) 0.001Vitamin B12 (pmol/l) +55.5 (136.7; 2485,+675) +0.3 (115.5; 2240,+282) 0.010Homocysteine (µmol/l) +1.6 (4.6;

220.1,+24.7) +2.6 (4.4; 217.1,+9.0) 0.194==============================================Data are mean (SD; range).*t test (baseline values were log transformed as they were positively skewed). Table 3 Logistic regression models for the association between baseline folate/vitamin B12/homocysteine and incident dementia over the 2.4 year follow-up period (n=518).============================================== OR (95% CI) for dementia per quintile difference Folate (lower) Vitamin B12 (lower) Homocysteine (higher)==============================================Unadjusted 1.29 (1.03 to 1.62) 1.09 (0.88 to 1.36) 1.11 (0.89 to 1.39)(1) Adjusted for age, sex and education 1.35 (1.06 to 1.73) 1.08 (0.86 to 1.35) 1.10 (0.86 to 1.40)(2) Model 1 plus disability and depression 1.39 (1.08 to 1.78) 1.07 (0.85 to 1.34) 1.10 (0.86 to 1.40)(3) Model

2 plus smoking, alcohol and activity 1.35 (1.05 to 1.74) 1.04 (0.82 to 1.32) 1.07 (0.83 to 1.38)(4) Model 3 plus vascular risk score 1.35 (1.05 to 1.74) 1.05 (0.83 to 1.32) 1.06 (0.82 to 1.37)(5) Model 4 plus serum creatinine 1.35 (1.05 to 1.74) 1.05 (0.83 to 1.32) 1.08 (0.83 to 1.40)(6) Model 5 plus vitamin intake 1.35 (1.05 to 1.74) 1.07 (0.84 to 1.36) 1.05 (0.81 to 1.37)(7) Model 6 plus baseline body weight 1.41 (1.08 to 1.82) 1.06 (0.83 to 1.34) 1.08 (0.83 to 1.41)(8) Model 7 plus folate concentration - - 1.03 (0.82 to 1.31) 0.99 (0.76 to 1.31)(9) Model 7 plus vitamin B12 concentration 1.40 (1.08 to 1.82) - - 1.07 (0.82 to 1.41)(10) Model 7 plus homocysteine concentration 1.41 (1.08 to 1.83) 1.04 (0.82 to 1.33) - - Table 4 Logistic regression models for the association between change in folate/vitamin B12/homocysteine concentrations and co-occurring dementia incidence over the 2.4 year follow-up period

(n=518).============================================== OR (95% CI) for dementia per quintile change Folate (decline) Vitamin B12 (decline) Homocysteine (increase)==============================================Unadjusted 1.50 (1.18 to 1.91) 1.38 (1.10 to 1.74) 1.35 (1.07 to 1.70)(1) Adjusted for age, sex and education 1.53 (1.19 to 1.97) 1.38 (1.09 to 1.74) 1.38 (1.08 to 1.75)(2) Model 1 plus disability and depression 1.58 (1.22 to 2.04) 1.40 (1.10 to 1.77) 1.41 (1.10 to 1.80)(3) Model 2 plus smoking, alcohol and activity 1.60 (1.23 to 2.09) 1.42 (1.11 to 1.81) 1.38 (1.08 to 1.77)(4) Model 3 plus vascular risk score 1.59 (1.22 to 2.08) 1.41 (1.11 to 1.80) 1.38 (1.08 to 1.76)(5) Model 4 plus serum creatinine 1.59 (1.22 to 2.07) 1.41 (1.11 to 1.80) 1.38 (1.08 to 1.76)(6) Model 5 plus vitamin intake 1.59 (1.22 to 2.08) 1.72 (1.24 to 2.37) 1.41 (1.10 to

1.81)(7) Model 6 plus weight change 1.47 (1.11 to 1.94) 1.67 (1.16 to 2.30) 1.30 (0.99 to 1.69)(8) Model 7 plus folate change - - 1.50 (1.03 to 2.19) 1.17 (0.89 to 1.55)(9) Model 7 plus vitamin B12 change 1.37 (1.03 to 1.82) - - 1.23 (0.93 to 1.61)(10) Model 7 plus homocysteine change 1.41 (1.06 to 1.88) 1.59 (1.10 to 2.29) - -

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