1
|
Flieger J, Żuk N, Pasieczna-Patkowska S, Flieger M, Panek R, Klepka T, Franus W. Optimization of Cyanocobalamin (Vitamin B 12) Sorption onto Mesoporous Superparamagnetic Iron Oxide Nanoparticles. Molecules 2024; 29:2094. [PMID: 38731585 PMCID: PMC11085275 DOI: 10.3390/molecules29092094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/21/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
The techniques used to detect and quantify cyanocobalamin (vitamin B12) vary considerably in terms of detection sensitivity, from the most sensitive, based on radioisotopes and mass spectrometry (MS) with limits of detection (LOD) in fg mL-1, to fluorescence (FL) and surface plasmon resonance (SPR) biosensors with LOD values in the range of a few µg mL-1. For accurate quantification of an analyte present at trace levels in complex biological matrices, a selective separation and enrichment step is required to overcome matrix interferences and ensure sufficient detection sensitivity. In this study, iron oxide magnetic nanoparticles (IONPs) were used for the extraction and initial preconcentration of cyanocobalamin (vitamin B12). In the dependence of the magnetization on the H-field (hysteresis loop), no coercivity and remanence values were found at 300 K, indicating the superparamagnetic properties of the tested IONPs. Perfluorinated acids were used as amphiphilic agents to allow the sorption of cyanocobalamin onto the IONPs. FT-IR/ATR spectroscopy was used to confirm the sorption of cyanocobalamin on the IONPs. The influence of the addition of a homologous series of perfluorinated acids such as trifluoroacetic acid (TFAA), heptafluorobutyric acid (HFBA), and trichloroacetic acid (TCAA) to the extraction mixture was tested considering their type, mass, and time required for effective sorption. The adsorption kinetics and isotherm, described by the Freundlich and Langmuir equations, were analyzed. The maximum adsorption capacity (qm) exceeded 6 mg g-1 and was 8.9 mg g-1 and 7.7 mg g-1 for HFBA and TCAA, respectively, as the most efficient additives. After the desorption process using aqueous KH2PO4 solution, the sample was finally analyzed spectrophotometrically and chromatographically. The IONP-based method was successfully applied for the isolation of cyanocobalamin from human urine samples. The results showed that the developed approach is simple, cheap, accurate, and efficient for the determination of traces of cyanocobalamin in biological matrices.
Collapse
Affiliation(s)
- Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A, 20-093 Lublin, Poland;
| | - Natalia Żuk
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A, 20-093 Lublin, Poland;
| | - Sylwia Pasieczna-Patkowska
- Department of Chemical Technology, Faculty of Chemistry, Maria Curie Skłodowska University, Pl. Maria Curie-Skłodowskiej 3, 20-031 Lublin, Poland;
| | - Michał Flieger
- Department of Forensic Medicine, Medical University of Lublin, ul. Jaczewskiego 8b, 20-090 Lublin, Poland;
| | - Rafał Panek
- Department of Geotechnics, Civil Engineering and Architecture Faculty, Lublin University of Technology, Nadbystrzycka 40, 20-618 Lublin, Poland; (R.P.); (W.F.)
| | - Tomasz Klepka
- Department of Technology and Polymer Processing, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka 36, 20-618 Lublin, Poland;
| | - Wojciech Franus
- Department of Geotechnics, Civil Engineering and Architecture Faculty, Lublin University of Technology, Nadbystrzycka 40, 20-618 Lublin, Poland; (R.P.); (W.F.)
| |
Collapse
|
2
|
Zhang Z, Li S, Wang S. Application of Periventricular White Matter Hyperintensities Combined with Homocysteine into Predicting Mild Cognitive Impairment in Parkinson's Disease. Int J Gen Med 2023; 16:785-792. [PMID: 36879618 PMCID: PMC9985451 DOI: 10.2147/ijgm.s399307] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
Purpose To verify the associations between white matter hyperintensities (WMHs), plasma homocysteine (Hcy) levels, and mild cognitive impairment (MCI) in Parkinson's disease (PD) patients and evaluate the predictive value of combination of WMHs and plasma Hcy levels for MCI. Patients and methods In this study, 387 patients with PD were divided into MCI group and non-MCI group. Their cognition was evaluated with a comprehensive neuropsychological evaluation including 10 tests. Five cognitive domains, including the memory, attention/working memory, visuospatial, executive and language domains, were evaluated using two tests for each domain. MCI was determined when at least two tests demonstrated abnormal results, either one impaired test in two different cognitive domains or two impaired tests in a single cognitive domain. Multivariate analysis was performed to determine risk factors for MCI in PD patients. The receiver operating characteristic (ROC) curve was employed to assess the predictive values, and the Z test was employed to compare the area under curve (AUC). Results MCI was identified in 195 PD patients with an incidence of 50.4%. Multivariate analysis results showed that PWMHs (OR: 5.162, 95% CI: 2.318~9.527), Hcy levels (OR: 1.189, 95% CI: 1.071~1.405) and MDS-UPDRS part III score (OR: 1.173, 95% CI: 1.062~1.394) were independently correlated with MCI in PD patients after adjusting for confounders. ROC curves showed that the AUCs of PWMHs, Hcy levels and their combination were 0.701 (SE: 0.026, 95% CI: 0.647~0.752), 0.688 (SE: 0.027, 95% CI: 0.635~0.742) and 0.879 (SE: 0.018, 95% CI: 0.844~0.915), respectively. Z test showed that the AUC of combination prediction was significantly higher than those of individual predictions (0.879 vs 0.701, Z=5.629, P<0.001; 0.879 vs 0.688, Z=5.886, P<0.001). Conclusion The combination of WMHs and plasma Hcy levels could be applied in the prediction of MCI in PD patients.
Collapse
Affiliation(s)
- Zuowen Zhang
- Department of Neurology, Chongqing University Jiangjin Hospital, Chongqing, People's Republic of China
| | - Shishuang Li
- Department of Neurology, Chongqing University Jiangjin Hospital, Chongqing, People's Republic of China
| | - Shumei Wang
- College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, People's Republic of China
| |
Collapse
|
3
|
Song Y, Quan M, Li T, Jia J. Serum Homocysteine, Vitamin B12, Folate, and Their Association with Mild Cognitive Impairment and Subtypes of Dementia. J Alzheimers Dis 2022; 90:681-691. [PMID: 36155508 DOI: 10.3233/jad-220410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although elevated levels of homocysteine (Hcy) are associated with cognitive impairment and dementia, the relevance of Hcy, vitamin B12, and folate levels to subtypes of dementia are still unknown. OBJECTIVE To investigate the changes of Hcy, vitamin B12, and folate levels in mild cognitive impairment (MCI) and subtypes of dementia including Alzheimer's disease (AD), vascular dementia (VaD), frontotemporal dementia (FTD), and Lewy body dementia (LBD), and their relationships with cognitive function and magnetic resonance imaging (MRI) markers. METHODS We measured serum levels of Hcy, vitamin B12, and folate in 257 subjects. Each subject underwent cognitive function assessment and brain MRI test. The Fazekas and temporal lobe atrophy (MTA) visual rating scales were used to assess the degree of white matter hyperintensities and MTA, respectively. RESULTS Serum levels of Hcy was higher and vitamin B12 was lower in AD, VaD, FTD, and LBD groups than cognitively normal controls. No significant differences of folate levels were found among 6 groups. Hcy levels were positively correlated with MTA total score in AD (r = 0.448, p < 0.001). Vitamin B12 levels were positively correlated with MoCA in VaD (r = 0.497), and negatively correlated with MTA total score in AD (r = - 0.325) (ps < 0.05). Hyperhomocysteinemia may increase the risk of AD (OR = 2.744), VaD (OR = 3.600), and FTD (OR = 3.244) in the adjusted model (ps < 0.05). CONCLUSION Hcy and vitamin B12 levels are associated with MTA in AD. Vitamin B12 levels are associated with general cognition in VaD. Hyperhomocysteinemia is a risk factor for not only AD and VaD but also FTD.
Collapse
Affiliation(s)
- Yang Song
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Meina Quan
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Tingting Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China
| | - Jianping Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China
| |
Collapse
|
4
|
Zhou J, Sun Y, Ji M, Li X, Wang Z. Association of Vitamin B Status with Risk of Dementia in Cohort Studies: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2022; 23:1826.e21-1826.e35. [PMID: 35779574 DOI: 10.1016/j.jamda.2022.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To examine the association between B vitamins status and the risk of dementia in older adults through a systematic review and meta-analysis of cohort studies. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Older adults aged ≥60 years from community, nursing home, institution, or hospital. METHODS PubMed, Cochrane Library, EMBASE, Web of Science, CINAHL, ClinicalTrials, WHO-ICTRP, NHS Trusts, and ACTR were searched from the date of their inception up to November 28, 2021. We included cohort studies that assessed the association between serum B vitamins or B vitamins intake and the risk of dementia among older adults aged ≥60 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale (NOS). The hazard ratios (HRs) and 95% CIs were calculated by the random effects model. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence. RESULTS Eleven cohort studies with sample sizes ranging from 233 to 3634 were included in the meta-analysis. Levels of serum folate showed statistically significant association with the risk of dementia (≥10 nmol/L: HR 1.57, 95% CI 1.01-2.46, low certainty; <10 nmol/L: HR 0.93, 95% CI 0.88-0.99, very low certainty). However, levels of vitamin B6 intake showed no statistically significant effects on risk of dementia; levels of serum vitamin B12 and vitamin B12 intake also showed no statistically significant effects on risk of dementia in older adults. CONCLUSIONS AND IMPLICATIONS The results from our meta-analysis suggest that vitamin B6, B12, and folate may not be modifiable risk factors for dementia among older adults. Current evidence on the relationship between vitamin B status and dementia is not sufficient for development of vitamin B recommendations. More high-quality cohort studies are needed to confirm the relationship between the two in the future.
Collapse
Affiliation(s)
- Jia Zhou
- School of Nursing, Peking university, Beijing, China
| | - Yue Sun
- School of Nursing, Peking university, Beijing, China
| | - Mengmeng Ji
- School of Nursing, Peking university, Beijing, China
| | - Xinrui Li
- School of Nursing, Peking university, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking university, Beijing, China.
| |
Collapse
|
5
|
Wang Q, Zhao J, Chang H, Liu X, Zhu R. Homocysteine and Folic Acid: Risk Factors for Alzheimer's Disease-An Updated Meta-Analysis. Front Aging Neurosci 2021; 13:665114. [PMID: 34122042 PMCID: PMC8188894 DOI: 10.3389/fnagi.2021.665114] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/09/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Recent studies have reported that homocysteine (Hcy) may play a vital role in the pathogenesis of vascular dementia (VaD) and Alzheimer's disease (AD). Our study explored the relationship between the plasma Hcy and folate levels and the risk of dementia. Methods: We searched Embase, PubMed, and Web of Science for published literature, including case-control studies and prospective cohort studies, and performed a systematic analysis. Results: The results of our meta-analysis, consisting of case-control studies, showed higher levels of Hcy and lower levels of folate in dementia, AD, and VaD patients than those in non-demented controls (for dementia: SMD = 0.812, 95% CI [0.689, 0.936], p = 0.000 for Hcy; SMD = −0.677, 95% CI [−0.828, −0.525], p = 0.000 for folate). AD patients showed significantly lower plasma Hcy levels compared to VaD patients (SMD = −0.278, 95% CI [−0.466, −0.09], p = 0.000). Subgroup analysis revealed that ethnicity, average age, and dementia type had no significant effect on this association. Furthermore, from the analysis of prospective cohort studies, we identified that elevated plasma Hcy levels were associated with an increased risk of dementia, AD, and VaD (RRdementia = 1.22, 95% CI [1.08, 1.36]; RRAD = 1.07, 95% CI [1.04, 1.11]; RRVaD = 1.13, 95% CI [1.04, 1.23]). In addition, every 5 μmol/L increase in the plasma Hcy level was associated with a 9% increased risk of dementia and a 12% increased risk of AD. Conclusion: Hcy and folic acid are potential predictors of the occurrence and development of AD. A better understanding of their function in dementia could provide evidence for clinicians to rationalize clinical intervention strategies.
Collapse
Affiliation(s)
- Qianwen Wang
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jingjing Zhao
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Hongtao Chang
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xu Liu
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ruixia Zhu
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| |
Collapse
|
6
|
Zhang X, Bao G, Liu D, Yang Y, Li X, Cai G, Liu Y, Wu Y. The Association Between Folate and Alzheimer's Disease: A Systematic Review and Meta-Analysis. Front Neurosci 2021; 15:661198. [PMID: 33935641 PMCID: PMC8079632 DOI: 10.3389/fnins.2021.661198] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/17/2021] [Indexed: 12/20/2022] Open
Abstract
Alzheimer's disease (AD) is the most common type of neurodegenerative disease leading to dementia in the elderly. Increasing evidence indicates that folate plays an important role in the pathogenesis of AD. To investigate the role of folate deficiency/possible deficiency in the risk of AD and the benefical effect of sufficient folate intake on the prevention of AD, a systematic review and meta-analysis were performed. The Web of Science, PubMed, CENTRAL, EBSCO, CNKI, CQVIP, and Wanfang databases were searched. The analysis of cross-sectional studies showed that the standardized mean difference (SMD) was −0.60 (95% confidence interval (CI): −0.65, −0.55), indicating that plasma/serum folate level is lower in AD patients than that in controls. Moreover, the combined odds ratio (OR) of case-control studies was 0.96 (95% CI: 0.93, 0.99), while the combined ORs were 0.86 (95% CI: 0.46, 1.26) and 1.94 (95% CI: 1.02, 2.86) in populations with normal levels of folate (≥13.5 nmol/L) and folate deficiency/possible deficiency (<13.5 nmol/L), respectively. In addition, the risk ratio (RR) of the cohort studies was 1.88 (95% CI: 1.20, 2.57) in populations with folate deficiency/possible deficiency. Furthermore, when the intake of folate was equal to or higher than the recommended daily allowance, the combined RR and hazard ratio (HR) were 0.44 (95% CI: 0.18, 0.71) and 0.76 (95% CI: 0.52, 0.99), respectively. These results indicate that folate deficiency/possible deficiency increases the risk for AD, while sufficient intake of folate is a protective factor against AD.
Collapse
Affiliation(s)
- Xiaohong Zhang
- College of Marine Life Sciences, Ocean University of China, Qingdao, China.,Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China
| | - Guangyi Bao
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China
| | - Debiao Liu
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China
| | - Yu Yang
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China.,Center of Evidence-Based Medicine, Jining Medical University, Jining, China
| | - Xuezhi Li
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China.,Center of Evidence-Based Medicine, Jining Medical University, Jining, China
| | - Gaomei Cai
- Department of Neurology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
| | - Yan Liu
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China.,Center of Evidence-Based Medicine, Jining Medical University, Jining, China
| | - Yili Wu
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China.,Center of Evidence-Based Medicine, Jining Medical University, Jining, China
| |
Collapse
|
7
|
Effects of Vitamin B12 Supplementation on Cognitive Function, Depressive Symptoms, and Fatigue: A Systematic Review, Meta-Analysis, and Meta-Regression. Nutrients 2021; 13:nu13030923. [PMID: 33809274 PMCID: PMC8000524 DOI: 10.3390/nu13030923] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 12/19/2022] Open
Abstract
Vitamin B12 is often used to improve cognitive function, depressive symptoms, and fatigue. In most cases, such complaints are not associated with overt vitamin B12 deficiency or advanced neurological disorders and the effectiveness of vitamin B12 supplementation in such cases is uncertain. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to assess the effects of vitamin B12 alone (B12 alone), in addition to vitamin B12 and folic acid with or without vitamin B6 (B complex) on cognitive function, depressive symptoms, and idiopathic fatigue in patients without advanced neurological disorders or overt vitamin B12 deficiency. Medline, Embase, PsycInfo, Cochrane Library, and Scopus were searched. A total of 16 RCTs with 6276 participants were included. Regarding cognitive function outcomes, we found no evidence for an effect of B12 alone or B complex supplementation on any subdomain of cognitive function outcomes. Further, meta-regression showed no significant associations of treatment effects with any of the potential predictors. We also found no overall effect of vitamin supplementation on measures of depression. Further, only one study reported effects on idiopathic fatigue, and therefore, no analysis was possible. Vitamin B12 supplementation is likely ineffective for improving cognitive function and depressive symptoms in patients without advanced neurological disorders.
Collapse
|
8
|
Lin H, Karjadi C, Ang TFA, Prajakta J, McManus C, Alhanai TW, Glass J, Au R. Identification of digital voice biomarkers for cognitive health. EXPLORATION OF MEDICINE 2020; 1:406-417. [PMID: 33665648 PMCID: PMC7929495 DOI: 10.37349/emed.2020.00028] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/04/2020] [Indexed: 01/03/2023] Open
Abstract
AIM Human voice contains rich information. Few longitudinal studies have been conducted to investigate the potential of voice to monitor cognitive health. The objective of this study is to identify voice biomarkers that are predictive of future dementia. METHODS Participants were recruited from the Framingham Heart Study. The vocal responses to neuropsychological tests were recorded, which were then diarized to identify participant voice segments. Acoustic features were extracted with the OpenSMILE toolkit (v2.1). The association of each acoustic feature with incident dementia was assessed by Cox proportional hazards models. RESULTS Our study included 6, 528 voice recordings from 4, 849 participants (mean age 63 ± 15 years old, 54.6% women). The majority of participants (71.2%) had one voice recording, 23.9% had two voice recordings, and the remaining participants (4.9%) had three or more voice recordings. Although all asymptomatic at the time of examination, participants who developed dementia tended to have shorter segments than those who were dementia free (P < 0.001). Additionally, 14 acoustic features were significantly associated with dementia after adjusting for multiple testing (P < 0.05/48 = 1 × 10-3). The most significant acoustic feature was jitterDDP_sma_de (P = 7.9 × 10-7), which represents the differential frame-to-frame Jitter. A voice based linear classifier was also built that was capable of predicting incident dementia with area under curve of 0.812. CONCLUSIONS Multiple acoustic and linguistic features are identified that are associated with incident dementia among asymptomatic participants, which could be used to build better prediction models for passive cognitive health monitoring.
Collapse
Affiliation(s)
- Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
| | - Cody Karjadi
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Ting F. A. Ang
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Slone Epidemiology Center, Boston University School of Medicine, Boston, MA 02118, USA
| | - Joshi Prajakta
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Chelsea McManus
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Tuka W. Alhanai
- Department of Electrical and Computer Engineering, New York University Abu Dhabi, Abu Dhabi, UAE
| | - James Glass
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Rhoda Au
- The Framingham Heart Study, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
- Slone Epidemiology Center, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
| |
Collapse
|
9
|
Ventura P, Corradini E, Di Pierro E, Marchini S, Marcacci M, Cuoghi C, Buzzetti E, Pietrangelo A. Hyperhomocysteinemia in patients with acute porphyrias: A potentially dangerous metabolic crossroad? Eur J Intern Med 2020; 79:101-107. [PMID: 32487371 DOI: 10.1016/j.ejim.2020.04.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/19/2020] [Accepted: 04/01/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Acute porphyrias (AP) are characterized by heme deficiency and induction of hepatic 5-aminolevulinate synthase (ALAS1). Hyperhomocysteinemia (HHcy) is associated with endothelial damage, neurotoxicity and increased risk for vascular diseases. Interestingly, both heme biosynthesis and sulphur amino acid metabolism require vitamin B6, (Pyridoxal-phosphate, PLP) an important cofactor of ALAS1 and of cystathionine β-synthase (CBS) and cystathionine γ-lyase (CGL) enzymes that catabolize homocysteine (Hcy). Moreover, heme itself is an important cofactor for CBS. AIM to assess plasma Hcy status and HHcy main determinants in patients with AP. MATERIALS AND METHODS A total of 46 patients with AP (31 with Acute Intermittent Porphyria,15 with Variegate Porphyria) were assessed for clinical status (symptomatic vs. asymptomatic), serum Hcy, Cysteine (Cys), Vit.B6, Vit.B12, red blood cell folates and urinary delta-aminolevulinic acid (ALA) and porphobilinogen(PBG) levels (mean of six measurements). RESULTS Symptomatic AP patients had significantly higher urinary ALA and PBG levels, plasma Hcy, HHcy prevalence and Hcy/Cys ratio when compared to asymptomatic carriers of AP. Even though no significant correlation was observed between ALA/PBG urinary levels and serum Hcy levels, patients with higher levels of ALA and PBG had significantly higher levels of Hcy, a higher prevalence of moderate-to severe HHcy and serum PLP levels below the 25th percentile of a reference assessment with 300 healthy Italian subjects(<45nmol/L). CONCLUSIONS Most patients with symptomatic AP present HHcy resulting from alterations in sulphur amino acid metabolism. HHcy may represent an indirect marker of ALAS1 induction and its prevalence may be suggestive of a role of HHcy in the pathogenesis and/or comorbidities of AP.
Collapse
Affiliation(s)
- Paolo Ventura
- Unit of Internal Medicine, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy.
| | - Elena Corradini
- Unit of Internal Medicine, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy
| | - Elena Di Pierro
- Department of Internal Medicine, IRCCS Cà Granda Foundation, University of Milan, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Marchini
- Unit of Internal Medicine, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy
| | - Matteo Marcacci
- Unit of Internal Medicine, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy
| | - Chiara Cuoghi
- Unit of Internal Medicine, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy
| | - Elena Buzzetti
- Unit of Internal Medicine, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy
| | - Antonello Pietrangelo
- Unit of Internal Medicine, Department of Medical and Surgical Science for Children and Adults, University of Modena and Reggio Emilia, Italy
| |
Collapse
|
10
|
Beydoun MA, Tajuddin SM, Shaked D, Beydoun HA, Evans MK, Zonderman AB. One-carbon metabolism gene polymorphisms are associated with cognitive trajectory among African-American adults. Neurobiol Aging 2019; 84:238.e5-238.e18. [PMID: 31208817 DOI: 10.1016/j.neurobiolaging.2019.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 02/04/2019] [Accepted: 05/16/2019] [Indexed: 11/30/2022]
Abstract
The sex-specific link between longitudinal annual rate of cognitive change (LARCC) and polymorphisms in one-carbon metabolism enzymatic genes remains unclear, particularly among African-American adults. We tested associations of 14 single nucleotide polymorphisms (SNPs) from MTHFR, MTRR, MTR, and SHMT genes and select MTHFR haplotypes and latent classes (SNPHAP/SNPLC) with LARCC. Up to 797 African-American participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study (age: 30-64 y, 52% women) had 1.6-1.7 (i.e., 1 or 2) repeated measures (follow-up time, mean = 4.69 y) on 9 cognitive test scores, reflecting verbal and visual memory, verbal fluency, psychomotor speed, attention, and executive function: California Verbal Learning Test-immediate recall (CVLT-List A), CVLT-DFR (delayed free recall), Benton Visual Retention Test (BVRT), Animal Fluency (AF), Digits Span Forward and Backward tests, and Trail Making Test parts A and B (Trails A and B). Multiple linear mixed-effects and multiple linear regression models were conducted. Overall, MTHFR SNPs rs4846051(A1317G, G>A) and rs1801131(A1298C, G>T) were associated with slower and faster declines on AF, respectively, whereas rs2066462(C1056T, A>G) was related to slower decline on Trails B (executive function). Among men, rs4846051(A1317G, G>A) was linked to faster decline on BVRT (visual memory), whereas rs2066462(C1056T, A>G) and rs9651118(C>T) were associated with slower decline on CVLT-List A and rs9651118(C>T) with faster decline on CVLT-DFR. Among women, a slower decline on the domain "verbal memory/fluency" was observed with rs1801133(C677T, A>G). MTHFR2SNPHAP [rs1801133(C677T, A>G)/rs1801131(A1298C, G>T): GG] was associated with slower decline on AF among women, whereas MTHFR3SNPHAP(AT) was linked with slower decline on CVLT-List A among men but faster decline on "verbal memory/fluency" among women. Similar patterns were observed for MTHFR SNPLCs. In sum, MTHFR gene variations can differentially impact longitudinal changes in multiple cognitive domains among African-American adults.
Collapse
Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
| | - Salman M Tajuddin
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | - Danielle Shaked
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA; Department of Psychology, University of Maryland Baltimore County, Catonsville, MD, USA
| | - Hind A Beydoun
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA
| |
Collapse
|
11
|
Onaolapo AY, Obelawo AY, Onaolapo OJ. Brain Ageing, Cognition and Diet: A Review of the Emerging Roles of Food-Based Nootropics in Mitigating Age-related Memory Decline. Curr Aging Sci 2019; 12:2-14. [PMID: 30864515 PMCID: PMC6971896 DOI: 10.2174/1874609812666190311160754] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/16/2019] [Accepted: 02/27/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Age-related cognitive decline has been suggested to result from an increase in the brain neuron loss, which is attributable to continued derangement of the brain's oxidant/ antioxidant balance. Increased oxidative stress and a concomitant decrease in the brain's antioxidant defense system have been associated with functional senescence and organismal ageing. However, nature has configured certain foods to be rich sources of nootropic agents, with research showing that increased consumption of such foods or food ingredients may be protective against ageing-related memory decline. This knowledge is becoming increasingly valuable in an era when the boundary that separates food from medicine is becoming blurred. In this review, we examine extant literature dealing with the impact of ageing on brain structure and function, with an emphasis on the roles of oxidative stress. Secondly, we review the benefits of food-based antioxidants with nootropic effects and/or food-based nootropic agents in mitigating memory decline; with a view to improving our understanding of likely mechanisms. We also highlight some of the limitations to the use of food-based nootropics and suggest ways in which they can be better employed in the clinical management of age-related cognitive decline. CONCLUSION While it is known that the human brain endures diverse insults in the process of ageing, food-based nootropics are likely to go a long way in mitigating the impacts of these insults. Further research is needed before we reach a point where food-based nootropics are routinely prescribed.
Collapse
Affiliation(s)
| | | | - Olakunle James Onaolapo
- Address correspondence to this author at the Behavioural Neuroscience/Neuropharmacology Unit, Department of Pharmacology, Ladoke
Akintola University of Technology, Osogbo, Osun State, Nigeria;
Tel: 2347031986101; E-mail:
| |
Collapse
|
12
|
Burke SL, Cadet T, Maddux M. Chronic Health Illnesses as Predictors of Mild Cognitive Impairment Among African American Older Adults. J Natl Med Assoc 2018; 110:314-325. [PMID: 30126555 PMCID: PMC6108440 DOI: 10.1016/j.jnma.2017.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 06/14/2017] [Accepted: 06/21/2017] [Indexed: 12/19/2022]
Abstract
Approximately 5.5 million individuals are diagnosed with Alzheimer's disease (AD) dementia, a number which includes those with mild cognitive impairment and asymptomatic individuals with biomarkers of AD. There is a higher incidence of mild cognitive impairment (MCI) in African American populations as compared to White populations, even when controlling for sociodemographic factors. The existing body of ethnically/racially targeted research on MCI has been limited by few studies with the ability to generalize to African American communities. This study sought to examine whether medical conditions which occur at a higher rate in African American individuals increase the hazard of subsequent MCI development. A secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was employed to examine the associations between health conditions (congestive heart failure, traumatic brain injury, diabetes, hypertension, hypercholesterolemia, B12 deficiency, thyroid disease) and their relationship to MCI. The analytic sample included 2847 participants with 9872 observations. Binary logistic generalized estimating equation modeling was used to examine repeated measures over the course of 1-11 observations. Education was associated with MCI development, specifically those with some college or college graduates (p < 0.001) and more than college (p = 0.002). Female sex was associated with development of MCI (p < 0.001). African Americans with traumatic brain injury (TBI) were more likely to develop MCI (p < 0.001) compared to those with no reports of a TBI. Inactive thyroid conditions decreased the risk of MCI development (p = 0.005) compared to those without thyroid disease. Though vascular factors are often attributed to higher mortality and neurodegeneration in African Americans, congestive heart failure, diabetes, high cholesterol, hypertension, diabetes, nor seizures were associated with an increased risk of MCI development. Findings from this study provide formative data to develop targeted interventions for subsets of the African American community, including those with higher educational levels, those with TBI, and those with a history of thyroid disease. While it may not be possible to prevent MCI development, it is possible to modify lifestyle behaviors contributing to these health conditions, such as falls that are often experienced by older adults. Practitioners can increase awareness, knowledge, and resources relevant to clients.
Collapse
Affiliation(s)
- Shanna L Burke
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, 11200 S.W. 8th Street, AHC5 564 Miami, FL 33199, USA.
| | - Tamara Cadet
- Simmons College School of Social Work, HSDM-Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, USA
| | - Marlaina Maddux
- Florida International University, Robert Stempel College of Public Health and Social Work, School of Social Work, 11200 S.W. 8th Street, AHC5 564 Miami, FL 33199, USA
| |
Collapse
|
13
|
Min JY, Min KB. The Folate-Vitamin B12 Interaction, Low Hemoglobin, and the Mortality Risk from Alzheimer's Disease. J Alzheimers Dis 2017; 52:705-12. [PMID: 27003215 DOI: 10.3233/jad-151095] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Abnormal hemoglobin levels are a risk factor for Alzheimer's disease (AD). Although the mechanism underlying these associations is elusive, inadequate micronutrients, particularly folate and vitamin B12, may increase the risk for anemia, cognitive impairment, and AD. In this study, we investigated whether the nutritional status of folate and vitamin B12 is involved in the association between low hemoglobin levels and the risk of AD mortality. Data were obtained from the 1999-2006 National Health and Nutrition Examination Survey (NHANES) and the NHANES (1999-2006) Linked Mortality File. A total of 4,688 participants aged ≥60 years with available baseline data were included in this study. We categorized three groups based on the quartiles of folate and vitamin B12 as follows: Group I (low folate and vitamin B12); Group II (high folate and low vitamin B12 or low folate and high vitamin B12); and Group III (high folate and vitamin B12). Of 4,688 participants, 49 subjects died due to AD. After adjusting for age, sex, ethnicity, education, smoking history, body mass index, the presence of diabetes or hypertension, and dietary intake of iron, significant increases in the AD mortality were observed in Quartile1 for hemoglobin (HR: 8.4, 95% CI: 1.4-50.8), and the overall risk of AD mortality was significantly reduced with increases in the quartile of hemoglobin (p for trend = 0.0200), in subjects with low levels of both folate and vitamin B12 at baseline. This association did not exist in subjects with at least one high level of folate and vitamin B12. Our finding shows the relationship between folate and vitamin B12 levels with respect to the association between hemoglobin levels and AD mortality.
Collapse
Affiliation(s)
- Jin-Young Min
- Department of Epidemiology, Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
14
|
The Protective Effects of Icariin against the Homocysteine-Induced Neurotoxicity in the Primary Embryonic Cultures of Rat Cortical Neurons. Molecules 2016; 21:molecules21111557. [PMID: 27879670 PMCID: PMC6274412 DOI: 10.3390/molecules21111557] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/26/2016] [Accepted: 11/09/2016] [Indexed: 11/18/2022] Open
Abstract
Icariin, an ingredient in the medicinal herb Epimedium brevicornum Maxim (EbM), has been considered as a potential therapeutic agent for neurodegenerative diseases such as Alzheimer’s disease (AD). Hyperhomocysteinaemia is a risk factor for AD and other associated neurological diseases. In this study we aim to investigate whether icariin can reverse homocysteine (Hcy)-induced neurotoxicity in primary embryonic cultures of rat cortical neurons. Our findings demonstrated that icariin might be able restore the cytoskeleton network damaged by Hcy through the modulation of acetyl-α-tubulin, tyrosinated-α-tubulin, and phosphorylation of the tubulin-binding protein Tau. In addition, icariin downregulated p-extracellular signal-regulated kinase (ERK) which is a kinase targeting tau protein. Furthermore, icariin effectively restored the neuroprotective protein p-Akt that was downregulated by Hcy. We also applied RT2 Profiler PCR Arrays focused on genes related to AD and neurotoxicity to examine genes differentially altered by Hcy or icariin. Among the altered genes from the arrays, ADAM9 was downregulated 15 folds in cells treated with Hcy, but markedly restored by icariin. ADAM family, encoded α-secreatase, plays a protective role in AD. Overall, our findings demonstrated that icariin exhibits a strong neuroprotective function and have potential for future development for drug treating neurological disorders, such as AD.
Collapse
|
15
|
Shen L, Ji HF. Associations between Homocysteine, Folic Acid, Vitamin B12 and Alzheimer's Disease: Insights from Meta-Analyses. J Alzheimers Dis 2016; 46:777-90. [PMID: 25854931 DOI: 10.3233/jad-150140] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The associations between homocysteine (Hcy), folic acid, and vitamin B12 and Alzheimer's disease (AD) have gained much interest, while remaining controversial. We aim to perform meta-analyses to evaluate comprehensively: i) Hcy, folic acid, and vitamin B12 levels in AD patients in comparison with controls; and ii) the association between Hcy, folic acid, and vitamin B12 levels and risk of AD. A literature search was performed using Medline and Scopus databases. A total of 68 studies were identified and included in the meta-analyses. Stata 12.0 statistical software was used to perform the meta-analyses. First, AD patients may have higher level of Hcy, and lower levels of folate and vitamin B12 in plasma than controls. Further age-subgroup analysis showed no age effect for Hcy levels in plasma between AD patients and matched controls, while the differences in folate and vitamin B12 levels further enlarged with increased age. Second, data suggests that high Hcy and low folate levels may correlate with increased risk of AD occurrence. The comprehensive meta-analyses not only confirmed higher Hcy, lower folic acid, and vitamin B12 levels in AD patients than controls, but also implicated that high Hcy and low folic acid levels may be risk factors of AD. Further studies are encouraged to elucidate mechanisms linking these conditions.
Collapse
|
16
|
Abstract
Cognitive decline is an increasingly important public health problem, with more than 100 million adults worldwide projected to develop dementia by 2050. Accordingly, there has been an increased interest in preventive strategies that diminish this risk. It has been recognized that lifestyle factors including dietary patterns, may be important in the prevention of cognitive decline and dementia in later life. Several dietary components have been examined, including antioxidants, fatty acids, and B vitamins. In addition, whole dietary eating plans, including the Mediterranean diet (MeDi), and the Dietary Approaches to Stop Hypertension (DASH) diet, with and without weight loss, have become areas of increasing interest. Although prospective epidemiological studies have observed that antioxidants, fatty acids, and B vitamins are associated with better cognitive functioning, randomized clinical trials have generally failed to confirm the value of any specific dietary component in improving neurocognition. Several randomized trials have examined the impact of changing 'whole' diets on cognitive outcomes. The MeDi and DASH diets offer promising preliminary results, but data are limited and more research in this area is needed.
Collapse
Affiliation(s)
- P J Smith
- Department of Psychiatry and Behavioral Sciences at Duke University Medical Center, Durham, USA
| | - J A Blumenthal
- Department of Psychiatry and Behavioral Sciences at Duke University Medical Center, Durham, USA
| |
Collapse
|
17
|
Khodabandehloo N, Vakili M, Hashemian Z, Zare Zardini H. Determining Functional Vitamin B12 Deficiency in the Elderly. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e13138. [PMID: 26430518 PMCID: PMC4585337 DOI: 10.5812/ircmj.17(6)2015.13138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 01/29/2014] [Accepted: 12/14/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Elevated concentration of serum total homocysteine usually occurs in vitamin B-12 deficiency. This metabolite can be measured and used for screening functional vitamin B-12 deficiency. OBJECTIVES We assessed functional vitamin B12 deficiency in Tehranian elderly admitted to elderly research center, University of Social Welfare and Rehabilitation Sciences. PATIENTS AND MATERIALS A cross-sectional study was performed on 232 elderly admitted to elderly research center in Tehran, Iran in 2012. According to other studies, individuals were classified into two groups: high risk of vitamin B-12 deficiency (< 220 pmol/L) and borderline vitamin B-12 (220-258 pmol/L) accompanied by elevated homocysteine (> 15 micmol/L). RESULTS Cut-off of 15.0 pmol/L for homocysteine was identified for persons with normal or elevated concentrations. Among persons aged 65-74 and ≥ 75 years, respectively, 56% and 93% were at high risk of vitamin B-12 deficiency. CONCLUSIONS The prevalence of B12 deficiency was higher in this study compared to other studies, so more attention and massive efficacious policy should be designed to reduce the deficiency of this vitamin.
Collapse
Affiliation(s)
| | - Masoud Vakili
- Department of Hematology and Oncology, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Zahra Hashemian
- Department of Pediatrics, Hematology, Oncology and Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
- Corresponding Author: Zahra Hashemian, Department of Pediatrics, Hematology, Oncology and Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran, Tel: +98-3518224000, Fax: +98-3518224100, E-mail:
| | - Hadi Zare Zardini
- Department of Pediatrics, Hematology, Oncology and Genetics Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
- Young Researchers and Elite Club, Yazd Branch, Islamic Azad University, Yazd, IR Iran
| |
Collapse
|
18
|
Colapinto CK, O'Connor DL, Sampson M, Williams B, Tremblay MS. Systematic review of adverse health outcomes associated with high serum or red blood cell folate concentrations. J Public Health (Oxf) 2015; 38:e84-97. [PMID: 26160024 DOI: 10.1093/pubmed/fdv087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To examine the relationship between reported high serum or red blood cell (RBC) folate status and adverse health outcomes. METHODS We systematically searched PubMed/Medline and EMBASE (to May 2013), with no limits by study type, country or population, to identify studies reporting high folate concentrations in association with adverse health outcomes. Two reviewers screened studies and extracted data. Study quality was assessed. RESULTS We included 51 articles, representing 46 studies and 71 847 participants. Quantiles were used by 96% of studies to identify high folate concentrations. Eighty-three percent of serum folate and 50% of RBC folate studies reported a high folate cutoff that corresponded with a clinically normal concentration. Increasing values of reported high folate concentration did not demonstrate a consistent association with risk of adverse health outcomes. Overall, reported high folate concentrations appeared to be associated with a decreased risk of adverse health outcomes, though substantial methodological heterogeneity precluded complex analyses. CONCLUSIONS Our interpretation was complicated by methodological variability. High folate cutoffs varied and often corresponded with normal or desirable blood concentrations. In general, a negative association appeared to exist between reported high folate status and adverse health outcomes. Consistent methods and definitions are needed to examine high folate status and ultimately inform public health interventions.
Collapse
Affiliation(s)
- Cynthia K Colapinto
- Healthy Active Living and Obesity Research, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario K1H 8L1, Canada University of Ottawa, Ottawa, Ontario, Canada
| | - Deborah L O'Connor
- The Hospital for Sick Children, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario K1H 8L1, Canada
| | - Brock Williams
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario K1H 8L1, Canada University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
19
|
Roy B, Trivedi R, Garg RK, Gupta PK, Tyagi R, Gupta RK. Assessment of functional and structural damage in brain parenchyma in patients with vitamin B12 deficiency: A longitudinal perfusion and diffusion tensor imaging study. Magn Reson Imaging 2015; 33:537-43. [PMID: 25708265 DOI: 10.1016/j.mri.2015.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 02/15/2015] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Vitamin B12 deficiency may cause neural tissue damage. Even in advanced stages, conventional imaging of brain usually appears normal in vitamin B12 deficient patients. The aim of this study was to assess the structural and functional changes in brain of patients with vitamin B12 deficiency before and after six weeks of vitamin B12 supplementation using diffusion tensor imaging and pseudo-continuous arterial spin labelling (PCASL). METHODS MR imaging including DTI and PCASL and neuropsychological tests (NPT) were performed in 16 patients with vitamin B12 deficiency and 16 controls before and after 6weeks of therapy. Cerebral blood flow (CBF) derived from PCASL and DTI indices was calculated in brain of patients with vitamin B12 deficiency and controls. RESULTS Patient with vitamin B12 deficiency showed altered neuropsychological scores and altered CBF as well as fractional anisotropy (FA) values in various brain regions as compared with controls. Both CBF values and neuropsychological scores showed complete reversibility at 6weeks post therapy. Though FA values showed significant recovery, it failed to show complete recovery. CONCLUSION Our results suggest that micro-structural recovery lags behind functional recovery in patients with vitamin B12 deficiency following therapy and CBF change may be used as an early predictor of complete recovery in patients with B12 deficiency.
Collapse
Affiliation(s)
- Bhaswati Roy
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - Richa Trivedi
- Institute of Nuclear Medicine and Allied Science, Delhi, India
| | - Ravindra K Garg
- Department of Neurology, King George Medical University, Lucknow, India
| | - Pradeep K Gupta
- Department of Neurology, King George Medical University, Lucknow, India
| | - Ritu Tyagi
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - Rakesh K Gupta
- Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India.
| |
Collapse
|
20
|
Inadequate supply of vitamins and DHA in the elderly: Implications for brain aging and Alzheimer-type dementia. Nutrition 2015; 31:261-75. [DOI: 10.1016/j.nut.2014.06.016] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/27/2014] [Accepted: 06/04/2014] [Indexed: 12/28/2022]
|
21
|
Yin Y, Fan Y, Lin F, Xu Y, Zhang J. Nutrient biomarkers and vascular risk factors in subtypes of mild cognitive impairment: a cross-sectional study. J Nutr Health Aging 2015; 19:39-47. [PMID: 25560815 DOI: 10.1007/s12603-014-0510-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate the interrelationships among blood nutrient biomarkers, the Framingham Stroke Risk Profile (FSRP), and cognitive impairment features in mild cognitive impairment (MCI) subjects and to verify whether nutrient biomarkers and FSRP are risk factors for MCI. METHODS According to the criteria for MCI developed by Petersen, 81 subjects aged 50-80 years were divided into a normal control group (NC group, n = 36) and an MCI group (n = 45). Then, the MCI group was divided into an amnestic MCI (a-MCI) and a multidomain MCI (md-MCI) group. All subjects were administered a comprehensive health history to calculate their FSRP score and a thorough neuropsychological assessment of four cognitive domains. Blood samples from all subjects were collected to measure the nutrient biomarkers. RESULTS FSRP score was not only associated with memory function, but also with executive function, which itself had a negative relationship with eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and total n-3 polyunsaturated fatty acids (n-3PUFAs) levels, and a positive relationship with the ratio of n-6 PUFAs to n-3 PUFAs(n6/n3). Compared with the NC group, the concentrations of EPA, DHA, 25-hydroxy vitamin D (25OHD), and folate and the ratio of n3/n6 in the md-MCI group were significantly lower. In the a-MCI group, only DHA concentrations and the ratio of n3/n6 were significantly lower. After adjustment for potential confounding variables, low education level [Adjusted OR=8.71 (95%CI: 1.83-41.50), p trend = 0.007], decreased plasma 25OHD [Adjusted OR = 4.41 (95% CI: 1.08-17.94), p trend=0.04] and decreased plasma DHA [Adjusted OR = 6.69 (95% CI: 1.37-32.72), p = 0.02] were associated with a higher risk of MCI. CONCLUSIONS Several nutrient biomarkers in MCI patients, especially in md-MCI patients, were lower compared with healthy controls, suggesting that lower 25OHD and DHA levels are risk factors for MCI. However, we found no evidence that FSRP is an early biomarker of MCI.
Collapse
Affiliation(s)
- Y Yin
- Junjian Zhang, Department of Neurology, Zhongnan Hospital, Wuhan University, No.169, Donghu Road, Wuhan 430071, Hubei, China, Tel. +86 139 86225751, E-Mail:
| | | | | | | | | |
Collapse
|
22
|
Haghdoost-Yazdi H, Sarookhani M, Faraj A, Fraidouni N, Dargahi T, Yaghoubidoust MH, Azhdari-Zarmehri H. Evaluation of the association between blood homocysteine concentration and the degree of behavioral symptoms in the 6-hydroxydopamine-induced Parkinsonism in rat. Pharmacol Biochem Behav 2014; 124:297-304. [DOI: 10.1016/j.pbb.2014.06.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 06/01/2014] [Accepted: 06/22/2014] [Indexed: 12/21/2022]
|
23
|
Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health 2014; 14:643. [PMID: 24962204 PMCID: PMC4099157 DOI: 10.1186/1471-2458-14-643] [Citation(s) in RCA: 461] [Impact Index Per Article: 46.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 05/13/2014] [Indexed: 12/15/2022] Open
Abstract
Background Cognitive impairment, including dementia, is a major health concern with the increasing aging population. Preventive measures to delay cognitive decline are of utmost importance. Alzheimer’s disease (AD) is the most frequent cause of dementia, increasing in prevalence from <1% below the age of 60 years to >40% above 85 years of age. Methods We systematically reviewed selected modifiable factors such as education, smoking, alcohol, physical activity, caffeine, antioxidants, homocysteine (Hcy), n-3 fatty acids that were studied in relation to various cognitive health outcomes, including incident AD. We searched MEDLINE for published literature (January 1990 through October 2012), including cross-sectional and cohort studies (sample sizes > 300). Analyses compared study finding consistency across factors, study designs and study-level characteristics. Selecting studies of incident AD, our meta-analysis estimated pooled risk ratios (RR), population attributable risk percent (PAR%) and assessed publication bias. Results In total, 247 studies were retrieved for systematic review. Consistency analysis for each risk factor suggested positive findings ranging from ~38.9% for caffeine to ~89% for physical activity. Education also had a significantly higher propensity for “a positive finding” compared to caffeine, smoking and antioxidant-related studies. Meta-analysis of 31 studies with incident AD yielded pooled RR for low education (RR = 1.99; 95% CI: 1.30-3.04), high Hcy (RR = 1.93; 95% CI: 1.50-2.49), and current/ever smoking status (RR = 1.37; 95% CI: 1.23-1.52) while indicating protective effects of higher physical activity and n-3 fatty acids. Estimated PAR% were particularly high for physical activity (PAR% = 31.9; 95% CI: 22.7-41.2) and smoking (PAR%=31.09%; 95% CI: 17.9-44.3). Overall, no significant publication bias was found. Conclusions Higher Hcy levels, lower educational attainment, and decreased physical activity were particularly strong predictors of incident AD. Further studies are needed to support other potential modifiable protective factors, such as caffeine.
Collapse
Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, 251 Bayview Blvd,, Suite 100, Room #: 04B118, Baltimore, MD 21224, USA.
| | | | | | | | | | | |
Collapse
|
24
|
Lopes da Silva S, Vellas B, Elemans S, Luchsinger J, Kamphuis P, Yaffe K, Sijben J, Groenendijk M, Stijnen T. Plasma nutrient status of patients with Alzheimer's disease: Systematic review and meta-analysis. Alzheimers Dement 2013; 10:485-502. [PMID: 24144963 DOI: 10.1016/j.jalz.2013.05.1771] [Citation(s) in RCA: 187] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 05/02/2013] [Accepted: 05/21/2013] [Indexed: 01/13/2023]
Abstract
BACKGROUND Alzheimer disease (AD) patients are at risk of nutritional insufficiencies because of physiological and psychological factors. Nutritional compounds are postulated to play a role in the pathophysiological processes that are affected in AD. We here provide the first systematic review and meta-analysis that compares plasma levels of micronutrients and fatty acids in AD patients to those in cognitively intact elderly controls. A secondary objective was to explore the presence of different plasma nutrient levels between AD and control populations that did not differ in measures of protein/energy nourishment. METHODS We screened literature published after 1990 in the Cochrane Central Register of Controlled Trials, Medline, and Embase electronic databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for AD patients, controls, micronutrient, vitamins, and fatty acids, resulting in 3397 publications, of which 80 met all inclusion criteria. Status of protein/energy malnutrition was assessed by body mass index, mini nutritional assessment score, or plasma albumin. Meta-analysis, with correction for differences in mean age between AD patients and controls, was performed when more than five publications were retrieved for a specific nutrient. RESULTS We identified five or more studies for folate, vitamin A, vitamin B12, vitamin C, vitamin D, vitamin E, copper, iron, and zinc but fewer than five studies for vitamins B1 and B6, long-chain omega-3 fatty acids, calcium, magnesium, manganese, and selenium (the results of the individual publications are discussed). Meta-analysis showed significantly lower plasma levels of folate and vitamin A, vitamin B12, vitamin C, and vitamin E (P < .001), whereas nonsignificantly lower levels of zinc (P = .050) and vitamin D (P = .075) were found in AD patients. No significant differences were observed for plasma levels of copper and iron. A meta-analysis that was limited to studies reporting no differences in protein/energy malnourishment between AD and control populations yielded similar significantly lower plasma levels of folate and vitamin B12, vitamin C, and vitamin E in AD. CONCLUSIONS The lower plasma nutrient levels indicate that patients with AD have impaired systemic availability of several nutrients. This difference appears to be unrelated to the classic malnourishment that is well known to be common in AD, suggesting that compromised micronutrient status may precede protein and energy malnutrition. Contributing factors might be AD-related alterations in feeding behavior and intake, nutrient absorption, alterations in metabolism, and increased utilization of nutrients for AD pathology-related processes. Given the potential role of nutrients in the pathophysiological processes of AD, the utility of nutrition may currently be underappreciated and offer potential in AD management.
Collapse
Affiliation(s)
- Sofia Lopes da Silva
- Nutricia Advanced Medical Nutrition, Nutricia Research, Utrecht, The Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Bruno Vellas
- Gerontopole and UMR INSERM 1027 University Paul Sabatier, Toulouse University Hospital, Toulouse, France
| | - Saskia Elemans
- Nutricia Advanced Medical Nutrition, Nutricia Research, Utrecht, The Netherlands
| | - José Luchsinger
- Department of Medicine, Columbia University, New York, NY, USA
| | - Patrick Kamphuis
- Nutricia Advanced Medical Nutrition, Nutricia Research, Utrecht, The Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Kristine Yaffe
- Department of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA, USA
| | - John Sijben
- Nutricia Advanced Medical Nutrition, Nutricia Research, Utrecht, The Netherlands.
| | - Martine Groenendijk
- Nutricia Advanced Medical Nutrition, Nutricia Research, Utrecht, The Netherlands
| | - Theo Stijnen
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
25
|
Kirsch SH, Herrmann W, Obeid R. Genetic defects in folate and cobalamin pathways affecting the brain. Clin Chem Lab Med 2013. [DOI: 10.1515/cclm-2012-0673] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
26
|
Haghdoost-Yazdi H, Fraidouni N, Faraji A, Jahanihashemi H, Sarookhani M. High intake of folic acid or complex of B vitamins provides anti-Parkinsonism effect: No role for serum level of homocysteine. Behav Brain Res 2012; 233:375-81. [DOI: 10.1016/j.bbr.2012.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 05/05/2012] [Accepted: 05/10/2012] [Indexed: 12/21/2022]
|
27
|
Blasko I, Hinterberger M, Kemmler G, Jungwirth S, Krampla W, Leitha T, Heinz Tragl K, Fischer P. Conversion from mild cognitive impairment to dementia: influence of folic acid and vitamin B12 use in the VITA cohort. J Nutr Health Aging 2012; 16:687-94. [PMID: 23076510 DOI: 10.1007/s12603-012-0051-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Increased serum homocysteine and low folate levels are associated with a higher rate of conversion to dementia. This study examined the influence of vitamin B12/folic acid intake on the conversion from mild cognitive impairment (MCI) to dementia. PARTICIPANTS A community dwelling cohort of older adults (N=81) from the Vienna Transdanube aging study with MCI. DESIGN Prospective study with a retrospective evaluation of vitamin intake. MEASUREMENTS Laboratory measurements, brain magnetic resonance imaging, and cognitive functioning were assessed at baseline and at five-year follow-up. RESULTS The self-reported combined use of folic acid and vitamin B12 for more than one year was associated with a lower conversion rate to dementia. Serum levels of homocysteine and vitamin B12 as measured at baseline or at five years were not associated with conversion. Higher folate levels at baseline in females predicted a lower conversion rate to dementia. The assessment of brain morphological parameters by magnetic resonance imaging revealed higher serum folate at baseline, predicting lower medial temporal lobe atrophy and higher levels of homocysteine at baseline, predicting moderate/severe global brain atrophy at five years. Users of vitamin B12 or folate, independent of time and pattern of use, had lower grades of periventricular hyperintensities and lower grades of deep white matter lesions as compared to non-users. CONCLUSIONS These results from a middle European study support observations on the protective ability of folate in MCI patients with respect to conversion to dementia; they also point to a participation of homocysteine metabolism on processes associated with brain atrophy.
Collapse
Affiliation(s)
- I Blasko
- Department of Psychiatry and Psychotherapy, Division of General and Social Psychiatry, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Sazci A, Ozel MD, Emel E, Idrisoglu HA. Gender-specific association of methylenetetrahydrofolate reductase gene polymorphisms with sporadic amyotrophic lateral sclerosis. Genet Test Mol Biomarkers 2012; 16:716-21. [PMID: 22385294 DOI: 10.1089/gtmb.2011.0313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Studies have revealed that elevated homocysteine levels can cause damage to motor neurons through multiple neurotoxic mechanisms, thus leading to the pathogenesis of amyotrophic lateral sclerosis (ALS). One way by which homocysteine levels are increased in the body is the consequence of methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. Therefore, to address this question, we studied the MTHFR C677T and A1298C polymorphisms in 437 sporadic ALS (SALS) and 439 healthy controls to learn whether they were associated with SALS. The overall SALS were not associated with MTHFR C677T and A1298C polymorphisms (χ(2)=1.378; p=0.502; χ(2)=1.304; p=0.521, respectively). However, when we stratified results in terms of gender, we found that the MTHFR C677T polymorphism (χ(2)=6.376; p=0.041), T677T genotype (χ(2)=5.508; p=0.019; odds ratio [OR]=2.561; 95% confidence interval [CI]=1.142-5.744), C677C/A1298A (χ(2)=5.216; p=0.022; OR=0.424, 95% CI=0.199-0.900), and T677T/A1298A (χ(2)=6.639; p=0.010; OR=2.900; 95% CI=1.252-6.717) compound genotypes were associated with SALS in female patients only. Moreover, stratification of SALS according to the onset of disease indicated that there was no association between MTHFR C677T (χ(2)=1.565; p=0.457; A1298C χ(2)=3.461; p=0.177) polymorphisms and overall spinal onset SALS. Further stratification analysis according to gender revealed that there was a remarkable association between MTHFR C677T (χ(2)=9.728, p=0.008), T677T genotype (χ(2)=7.820; p=0.005; OR=3.126; 95% CI=1.361-7.178) and T allele (χ(2)=5.000; p=0.025; OR=1.711; 95% CI=1.067-2.745), and T677T/A1298A compound genotype (χ(2)=9.108; p=0.003; OR=3.540; 95% CI=1.494-8.387) and spinal onset female SALS only. Likewise, there was also association between MTHFR A1298C polymorphism (χ(2)=5.946; p=0.051) and the C1298C genotype (χ(2)=5.282; p=0.022; OR=2.524; 95% CI=1.125-5.658), and the C677T/C1298C compound genotype (χ(2)=7.155; p=0.007; OR=1.045; 95% CI=0.983-1.112) and bulbar onset SALS only in women. In conclusion, the evidence we provide here clearly shows that MTHFR C677T and A1298C polymorphisms are genetic risk factors for SALS in women in a gender-specific manner whether they are of spinal or bulbar onset.
Collapse
Affiliation(s)
- Ali Sazci
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Kocaeli, Kocaeli, Turkey.
| | | | | | | |
Collapse
|
29
|
Macpherson H, Ellis KA, Sali A, Pipingas A. Memory improvements in elderly women following 16 weeks treatment with a combined multivitamin, mineral and herbal supplement: A randomized controlled trial. Psychopharmacology (Berl) 2012; 220:351-65. [PMID: 22006207 DOI: 10.1007/s00213-011-2481-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 08/31/2011] [Indexed: 11/26/2022]
Abstract
RATIONALE There is potential for multivitamin supplementation to improve cognition in the elderly. This randomized, double-blind, placebo-controlled trial was conducted to investigate the effects of 16 weeks multivitamin supplementation (Swisse Women's 50+ Ultivite ®) on cognition in elderly women. METHODS Participants in this study were 56 community dwelling, elderly women, with subjective complaints of memory loss. Cognition was assessed using a computerized battery of memory and attention tasks designed to be sensitive to age-related declines to fluid intelligence, and a measure of verbal recall. Biochemical measures of selected nutrients, homocysteine, markers of inflammation, oxidative stress, and blood safety parameters were also collected. All cognitive and haematological parameters were assessed at baseline and 16 weeks post-treatment. RESULTS The multivitamin improved speed of response on a measure of spatial working memory, however benefits to other cognitive processes were not observed. Multivitamin supplementation decreased levels of homocysteine and increased levels of vitamin B(6) and B(12), with a trend for vitamin E to increase. There were no hepatotoxic effects of the multivitamin formula indicating this supplement was safe for everyday usage in the elderly. CONCLUSION Sixteen weeks ssupplementation with a combined multivitamin, mineral and herbal formula may benefit working memory in elderly women at risk of cognitive decline.
Collapse
Affiliation(s)
- Helen Macpherson
- Centre for Human Psychopharmacology, NICM Collaborative Centre for Neurocognition, Swinburne University of Technology, 427-451 Burwood Road, Hawthorn, Melbourne, VIC, 3122, Australia.
| | | | | | | |
Collapse
|
30
|
Fuso A, Nicolia V, Ricceri L, Cavallaro RA, Isopi E, Mangia F, Fiorenza MT, Scarpa S. S-adenosylmethionine reduces the progress of the Alzheimer-like features induced by B-vitamin deficiency in mice. Neurobiol Aging 2012; 33:1482.e1-16. [PMID: 22221883 DOI: 10.1016/j.neurobiolaging.2011.12.013] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 12/05/2011] [Accepted: 12/06/2011] [Indexed: 10/14/2022]
Abstract
Methylation reactions linked to homocysteine in the one-carbon metabolism are increasingly elicited in Alzheimer's disease, although the association of hyperhomocysteinemia and of low B vitamin levels with the disease is still debated. We previously demonstrated that hyperhomocysteinemia and DNA hypomethylation induced by B vitamin deficiency are associated with PSEN1 and BACE1 overexpression and amyloid production. The present study is aimed at assessing S-adenosylmethionine effects in mice kept under a condition of B vitamin deficiency. To this end, TgCRND8 mice and wild-type littermates were assigned to control or B vitamin deficient diet, with or without S-adenosylmethionine supplementation. We found that S-adenosylmethionine reduced amyloid production, increased spatial memory in TgCRND8 mice and inhibited the upregulation of B vitamin deficiency-induced PSEN1 and BACE1 expression and Tau phosphorylation in TgCRND8 and wild-type mice. Furthermore, S-adenosylmethionine treatment reduced plaque spreading independently on B vitamin deficiency. These results strengthen our previous observations on the possible role of one-carbon metabolism in Alzheimer's disease, highlighting hyperhomocysteinemia-related mechanisms in dementia onset/progression and encourage further studies aimed at evaluating the use of S-adenosylmethionine as a potential candidate drug for the treatment of the disease.
Collapse
Affiliation(s)
- Andrea Fuso
- Department of Surgery P. Valdoni, Via Antonio Scarpa, 14-00161, Sapienza University of Rome, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Is high homocysteine level a risk factor for cognitive decline in elderly? A systematic review, meta-analysis, and meta-regression. Am J Geriatr Psychiatry 2011; 19:607-17. [PMID: 21705865 DOI: 10.1097/jgp.0b013e3181f17eed] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE [corrected] High homocysteine (Hct) has been causatively linked to Alzheimer disease (AD) and vascular dementia (VaD) in old age, but research methodologies and outcome measures are heterogeneous. It remains unclear whether the findings can be generalized across studies. METHODS Random-effects meta-analyses were conducted on studies examining the relationship between Hct level and risk of developing dementia/cognitive decline between comparison groups. Meta-regression identified patient- and trial-related factors, which may contribute to heterogeneity. RESULTS Seventeen relevant studies (6,122 participants; 13 cross-sectional and fourprospective studies) were included. Compared with controls, Hct was significantly elevated in AD (pooled standardized mean difference [SMD]: 0.59; 95% confidence interval [CI]: 0.38-0.80; significant heterogeneity: τ = 0.105) and VaD (pooled SMD: 1.30; 95% CI: 0.75-1.84; significant heterogeneity: τ = 0.378). Meta-regression identified mean age as significant moderator for AD versus controls and mean age and mean folate levels as significant moderators for VaD versus controls. Hct was significantly higher in VaD relative to AD (pooled SMD: 0.48; 95% CI: 0.23-0.73; moderately significant heterogeneity: τ = 0.076); proportion of men and mean folate levels were significant moderators. High-Hct level was not associated with risk of developing dementia in prospective studies (pooled odds ratio: 1.34; 95% CI: 0.94-1.91, nonsignificant heterogeneity: τ = 0.048). CONCLUSION Individuals with AD and VaD have higher Hct levels than controls; however, a causal relationship between high-Hct level and risk of developing dementia is not supported. More prospective studies and randomized controlled trials are required to test the therapeutic benefits of lowering Hct levels.
Collapse
|
32
|
Abstract
OBJECTIVE To compare serum folate levels between atopic asthmatics, non-atopic asthmatics, and healthy controls. METHODS This case-control study included 60 asthmatics with at least one positive skin prick test (SPT) reaction (atopic asthma group), 60 asthmatics with negative SPT reactions (non-atopic asthma group), and 60 healthy controls with no history of asthma or other allergic diseases, and with negative SPT reactions. Serum folate and total IgE levels were measured in all subjects. In addition, lung functions were assessed by spirometry. RESULTS Serum folate levels were significantly lower among the atopic asthma group [9.1 (4.9, 12.1) ng/mL] as compared to the non-atopic asthma group [11.3 (7.5, 14.8) ng/mL] and the control group [12.0 (8.3, 15.1) ng/mL], p= 0.001. Among atopic asthmatics, serum folate levels were inversely correlated with total serum IgE levels (r=-0.483, p<0.001), and the number of positive SPT reactions (r=-0.442, p<0.001). Atopic asthmatics with a total serum IgE ≤200 IU/mL had significantly higher levels of serum folate than those with a total serum IgE >200 IU/mL. Regression analysis showed that higher folate levels independently predicted lower total serum IgE levels. Folate was not found to be an independent predictor of asthma. No association was observed between serum folate levels and values of forced expiratory volume in 1s. CONCLUSION Among asthmatics, serum folate levels are significantly lower among atopics, and correlate inversely with the degree of atopy.
Collapse
Affiliation(s)
- Mohamed N Farres
- Department of Allergy and Clinical Immunology, Faculty of Medicine, Ain Shams University, Egypt.
| | | | | | | | | |
Collapse
|
33
|
Tageja N. Relationship between anemia and cognitive functions in the geriatric population. Eur J Intern Med 2010; 21:e26. [PMID: 20603029 DOI: 10.1016/j.ejim.2010.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Accepted: 05/11/2010] [Indexed: 11/17/2022]
|
34
|
Ho YS, So KF, Chang RCC. Anti-aging herbal medicine--how and why can they be used in aging-associated neurodegenerative diseases? Ageing Res Rev 2010; 9:354-62. [PMID: 19833234 DOI: 10.1016/j.arr.2009.10.001] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 10/05/2009] [Accepted: 10/06/2009] [Indexed: 12/30/2022]
Abstract
Aging is a universal biological process that leads to progressive and deleterious changes in organisms. From ancient time, mankind has already interested in preventing and keeping ourselves young. Anti-aging study is certainly not a new research area. Nowadays, the meaning of anti-aging has been changed from simply prolonging lifespan to increasing health span, which emphasizes more on the quality of life. This is the concept of healthy aging and prevention of pathological aging, which is associated with diseases. Keeping our brain functions as in young age is an important task for neuroscientists to prevent aging-associated neurological disorders, such as Alzheimer's diseases (AD) and Parkinson's disease (PD). The causes of these diseases are not fully understood, but it is believed that these diseases are affected by multiple factors. Neurodegenerative diseases can be cross-linked with a number of aging-associated conditions. Based on this, a holistic approach in anti-aging research seems to be more reasonable. Herbal medicine has a long history in Asian countries. It is believed that many of the medicinal herbs have anti-aging properties. Recent studies have shown that some medicinal herbs are effective in intervention or prevention of aging-associated neurological disorders. In this review, we use wolfberry and ginseng as examples to elaborate the properties of anti-aging herbs. The characteristics of medicinal herbs, especially their applications in different disease stages (prevention and intervention) and multi-targets properties, allow them to be potential anti-aging intervention in prevention and treatment of the aging-associated neurological disorders.
Collapse
|
35
|
Etgen T, Bickel H, Förstl H. Metabolic and endocrine factors in mild cognitive impairment. Ageing Res Rev 2010; 9:280-8. [PMID: 20109582 DOI: 10.1016/j.arr.2010.01.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Revised: 01/19/2010] [Accepted: 01/20/2010] [Indexed: 12/22/2022]
Abstract
Mild cognitive impairment (MCI) is a heterogeneous condition with cognitive changes between normal aging and dementia. Some forms of MCI are regarded as potential preclinical forms of dementia. The control of treatable somatic risk factors is of great relevance in patients with MCI, particularly as there is insufficient evidence for the efficacy of interventions targeting neurodegenerative processes, as used in manifest dementia. The etiology of MCI is varied including cerebrovascular risk factors and is also associated with metabolic and endocrine factors. Chronic kidney disease is a newly identified and independent risk factor for MCI. Testosterone substitution is useful if a low testosterone level is present but general screening for testosterone deficiency is not yet recommended. A relationship between MCI and vitamin D or subclinical thyroid dysfunction may exist, but the value of substitution is doubtful and requires large randomized placebo-controlled trials. Although an association between vitamin B12 deficiency or hyperhomocysteinemia and MCI is present, substitution of vitamin B12 or folate does not appear to prevent cognitive decline. Estrogen-only hormone replacement therapy may be considered only in younger postmenopausal women, but may have detrimental effects on cognitive function in older postmenopausal women. Other less familiar or unknown risk factors contributing to cognitive dysfunction should be identified as they are a potential target of prevention or intervention of MCI or dementia.
Collapse
|
36
|
Gharaibeh MY, Gahtan RA, Khabour OF, Alomari MA. Hyperhomocysteinemia, Low Folate, and Vitamin B12Deficiency in Elderly Living at Home and Care Residences: A Comparative Study. Lab Med 2010. [DOI: 10.1309/lm1p78ofxacyyhpq] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
37
|
Zoccolella S, Bendotti C, Beghi E, Logroscino G. Homocysteine levels and amyotrophic lateral sclerosis: A possible link. ACTA ACUST UNITED AC 2010; 11:140-7. [DOI: 10.3109/17482960902919360] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
38
|
Blehaut H, Mircher C, Ravel A, Conte M, de Portzamparc V, Poret G, Huon de Kermadec F, Rethore MO, Sturtz FG. Effect of leucovorin (folinic acid) on the developmental quotient of children with Down's syndrome (trisomy 21) and influence of thyroid status. PLoS One 2010; 5:e8394. [PMID: 20084109 PMCID: PMC2799517 DOI: 10.1371/journal.pone.0008394] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Accepted: 11/05/2009] [Indexed: 11/24/2022] Open
Abstract
Background Seven genes involved in folate metabolism are located on chromosome 21. Previous studies have shown that folate deficiency may contribute to mental retardation in Down's syndrome (DS). Methodology We investigated the effect of oral folate supplementation (daily dose of 1.0±0.3 mg/kg) on cognitive functions in DS children, aged from 3 to 30 months. They received 1 mg/kg leucovorin or placebo daily, for 12 months, in a single-centre, randomised, double-blind study. Folinic acid (leucovorin, LV) was preferred to folic acid as its bioavailability is higher. The developmental age (DA) of the patients was assessed on the Brunet-Lezine scale, from baseline to the end of treatment. Results The intent-to-treat analysis (113 patients) did not show a positive effect of leucovorin treatment. However, it identified important factors influencing treatment effect, such as age, sex, and concomitant treatments, including thyroid treatment in particular. A per protocol analysis was carried out on patients evaluated by the same examiner at the beginning and end of the treatment period. This analysis of 87 patients (43 LV-treated vs. 44 patients on placebo) revealed a positive effect of leucovorin on developmental age (DA). DA was 53.1% the normal value with leucovorin and only 44.1% with placebo (p<0.05). This positive effect of leucovorin was particularly strong in patients receiving concomitant thyroxin treatment (59.5% vs. 41.8%, p<0.05). No adverse event related to leucovorin was observed. Conclusion These results suggest that leucovorin improves the psychomotor development of children with Down's syndrome, at least in some subgroups of the DS population, particularly those on thyroxin treatment. Trial Registration ClinicalTrials.gov, NCT00294593
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Marie-Odile Rethore
- Institut Jerome Lejeune, Paris, France
- National Academy of Medicine, Paris, France
| | - Franck G. Sturtz
- Institut Jerome Lejeune, Paris, France
- Department of Biochemistry and Molecular Genetics, University of Limoges, Limoges, France
- * E-mail:
| |
Collapse
|
39
|
Rodriguez-Oroz MC, Lage PM, Sanchez-Mut J, Lamet I, Pagonabarraga J, Toledo JB, García-Garcia D, Clavero P, Samaranch L, Irurzun C, Matsubara JM, Irigoien J, Bescos E, Kulisevsky J, Pérez-Tur J, Obeso JA. Homocysteine and cognitive impairment in Parkinson's disease: a biochemical, neuroimaging, and genetic study. Mov Disord 2009; 24:1437-44. [PMID: 19452554 DOI: 10.1002/mds.22522] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The role of the plasma level of homocysteine (Hcy), as a primary outcome, and the effect of silent cerebrovascular lesions and genetic variants related to Hcy metabolism, as secondary outcomes, in the cognitive decline and dementia in Parkinson's disease (PD) were studied. This case-control study focused on 89 PD patients of minimum 10 years of evolution and older than 60 years, who were neuropsychologically classified either as cognitively normal (n = 37), having mild cognitive impairment (Petersen criteria) (n = 22), or suffering from dementia (DSM-IV) (n = 30), compared with cognitively normal age-matched control subjects (n = 30). Plasma levels of Hcy, vitamins B12 and B6, folic acid, polymorphisms in genes related to Hcy metabolism (MTHFR, MTR, MTRR, and CBS) and silent cerebrovascular events were analyzed. Plasma levels of Hcy were increased in PD patients (P = 0.0001). There were no differences between the groups of patients. The brain vascular burden was similar among PD groups. There was no association between polymorphisms in the studied genes and the Hcy plasma levels or cognitive status in PD patients. We found no evidence for a direct relationship between Hcy plasma levels and cognitive impairment and dementia in PD. No indirect effect through cerebrovascular disease or genetic background was found either.
Collapse
Affiliation(s)
- Maria C Rodriguez-Oroz
- Department of Neurology, University Clinic and Medical School of Navarra, Pamplona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Chacón IJ, Molero AE, Pino-Ramírez G, Luchsinger JA, Lee JH, Maestre GE. Risk of dementia associated with elevated plasma homocysteine in a latin american population. Int J Alzheimers Dis 2009; 2009. [PMID: 20798752 PMCID: PMC2925085 DOI: 10.4061/2009/632489] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2009] [Revised: 06/16/2009] [Accepted: 07/22/2009] [Indexed: 11/26/2022] Open
Abstract
The relationship between total homocysteine (tHcy) and dementia risk remains controversial, as the association varies among populations and dementia subtypes. We studied a Venezuelan population that has high prevalence of both elevated tHcy and dementia. We tested the hypotheses that (1) elevated tHcy is associated with increased dementia risk, (2) the risk is greater for vascular dementia (VaD) than for Alzheimer's disease (AD), and (3) a history of stroke may partly explain this association. 2100 participants (≥55 years old) of the Maracaibo Aging Study underwent standardized neurological, neuropsychiatric, and cardiovascular assessments. Elevated tHcy was significantly associated with dementia, primarily VaD. When history of stroke and other confounding factors were taken into account, elevated tHcy remained a significant risk factor in older (>66 years), but not in younger (55–66 years) subjects. Ongoing studies of this population may provide insight into the mechanism by which tHcy increases risk for dementia.
Collapse
Affiliation(s)
- Inara J Chacón
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | | | | | | | | | | |
Collapse
|
41
|
Barone P, Burn DJ, van Laar T, Hsu C, Poewe W, Lane RM. Rivastigmine versus placebo in hyperhomocysteinemic Parkinson's disease dementia patients. Mov Disord 2009; 23:1532-40. [PMID: 18581467 DOI: 10.1002/mds.21997] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The effects of rivastigmine versus placebo in Parkinson's disease dementia (PDD) patients with elevated or normal/low plasma homocysteine were determined. In this prospective analysis of a 24-week, randomly assigned, placebo-controlled study of rivastigmine in PDD, subpopulations comprised patients with plasma homocysteine >or=14 micromol/L (elevated) or <14 micromol/L (normal/low). Coprimary outcomes were the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Alzheimer Disease Cooperative Society-Clinical Global Impression of Change (ADCS-CGIC). Secondary outcomes included additional measures of cognition, including attention and executive function, daily function, and neuropsychiatric symptoms. Adverse events (AEs) were monitored. In total, 342 of 541 patients provided samples for analysis, from which 72% had elevated plasma homocysteine. Hyperhomocysteinemic patients showed treatment differences (rivastigmine vs. placebo) of 4.0 on ADAS-cog and 0.7 on ADCS-CGIC (both P < 0.01), and significant treatment differences on secondary outcomes. Rivastigmine- and placebo-treated hyperhomocysteinemic patients (16.5% and 14.6%) discontinued the study because of AEs. Patients with normal/low homocysteine showed no treatment differences on primary or secondary outcomes (1.4 on the ADAS-cog and 0.1 on ADCS-CGIC, both P = ns); 16.7% and 10.3% rivastigmine- and placebo-treated patients discontinued because of AEs. Elevated homocysteine was associated with greater rivastigmine treatment differences than normal/low homocysteine.
Collapse
Affiliation(s)
- Paolo Barone
- Dipartimento di Scienze Neurologiche, Università Federico II di Napoli, Naples, Italy.
| | | | | | | | | | | |
Collapse
|
42
|
Lucca U, Tettamanti M, Quadri P. The Italian version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD). Alzheimers Dement 2008; 4:310. [DOI: 10.1016/j.jalz.2008.05.2478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Accepted: 05/09/2008] [Indexed: 11/29/2022]
Affiliation(s)
- Ugo Lucca
- Instituto di Ricerche Farmacologiche “Mario Negri,”MilanItaly
| | | | | |
Collapse
|
43
|
Smith AD. The Worldwide Challenge of the Dementias: A Role for B Vitamins and Homocysteine? Food Nutr Bull 2008; 29:S143-72. [DOI: 10.1177/15648265080292s119] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Dementia has reached epidemic proportions, with an estimated 4.6 million new cases worldwide each year. With an aging world population, the prevalence of dementia will increase dramatically in the next few decades. Of the predicted 114 million who will have dementia in 2050, about three-quarters will live in less developed regions. Although strongly age-related, dementia is not an inevitable part of aging but is a true disease, caused by exposure to several genetic and nongenetic risk factors. Prevention will be possible when the nongenetic risk factors have been identified. Apart from age, more than 20 nongenetic risk factors have been postulated, but very few have been established by randomized intervention studies. Elevated blood concentrations of total homocysteine and low-normal concentrations of B vitamins (folate, vitamin B12, and vitamin B6) are candidate risk factors for both Alzheimer's disease and vascular dementia. Seventy-seven cross-sectional studies on more than 34,000 subjects and 33 prospective studies on more than 12,000 subjects have shown associations between cognitive deficit or dementia and homocysteine and/or B vitamins. Biologically plausible mechanisms have been proposed to account for these associations, including atrophy of the cerebral cortex, but a definite causal pathway has yet to be shown. Raised plasma total homocysteine is a strong prognostic marker of future cognitive decline, and is common in world populations. Low-normal concentrations of the B vitamins, the main determinant of homocysteine concentrations, are also common and occur in particularly vulnerable sections of the population, such as infants and elderly. Large-scale randomized trials of homocysteine-lowering vitamins are needed to see if a proportion of dementia in the world can be prevented.
Collapse
|
44
|
Bachmann CG, Guth N, Helmschmied K, Armstrong VW, Paulus W, Happe S. Homocysteine in restless legs syndrome. Sleep Med 2008; 9:388-92. [PMID: 17900981 DOI: 10.1016/j.sleep.2007.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2007] [Revised: 06/19/2007] [Accepted: 06/27/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE Total plasma homocysteine (tHcy) may be a risk factor for vascular diseases and is associated with renal failure or deficiency of vitamin B12 or folate. Recently, elevated tHcy concentrations were observed in patients with Parkinson's disease (PD), particularly those under levodopa treatment. Our objective was to determine whether changes in tHcy are also found in patients with restless legs syndrome (RLS) in relation to levodopa treatment and whether folate and vitamins B6 and B12 play a role in RLS. METHODS In a total of 228 subjects, tHcy and B vitamin status (vitamins B6 and B12, folate) were studied: 97 patients with idiopathic RLS (40 under levodopa therapy), 39 with PD (25 under levodopa therapy), and 92 healthy controls adjusted for age and gender. RESULTS No significant differences were observed in tHcy levels between RLS patients and controls or between the RLS groups without treatment or with levodopa or dopamine agonist treatment. Mean tHcy was significantly higher in PD patients (13.8 micromol/l) than in either RLS patients (11.7 micromol/l) or controls (11.0 micromol/l; p<0.001). There was an inverse association between tHcy and vitamin B12 in each group. CONCLUSIONS RLS and, in particular, levodopa treatment in RLS are not associated with hyperhomocysteinemia. Elevated tHcy could, however, be confirmed in PD patients.
Collapse
|
45
|
Vidal JS, Dufouil C, Ducros V, Tzourio C. Homocysteine, Folate and Cognition in a Large Community-Based Sample of Elderly People – The 3C Dijon Study. Neuroepidemiology 2008; 30:207-14. [DOI: 10.1159/000126914] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2007] [Accepted: 01/23/2008] [Indexed: 11/19/2022] Open
|
46
|
Abstract
PURPOSE OF REVIEW Homocysteine and B vitamins have been investigated in association with cognitive dysfunction in healthy and in multimorbid elderly patients. Whether reduction of hyperhomocystemia is reducing the risk of dementia or Alzheimer's disease is still under investigation. RECENT FINDINGS High homocysteine concentrations are associated with poorer cognitive function but can be influenced by a number of factors. The results of epidemiological studies are inconsistent in showing an association between elevated homocysteine levels and dementia or Alzheimer disease. Although prospective studies show a trend towards a benefit of homocysteine-related B vitamin substitution, consistent data are expected from upcoming clinical intervention trials. Data from recent clinical randomized trials including various cognitive tests, different aging groups and supplements in different doses are not sufficient to allow recommendation of homocysteine-reducing therapy with folate or vitamin B12 substitution. According to the published data it remains to be proven whether a reduction in homocysteine will improve cognitive performance. SUMMARY Homocysteine by itself is not a useful marker for screening cognitive decline, or Alzheimer disease but works as a surrogate parameter for malnutrition and organ insufficiency in the cognitive-declining patient.
Collapse
Affiliation(s)
- Ralf-Joachim Schulz
- Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Research Group on Geriatrics at 'Ev. Geriatriezentrum Berlin', Berlin, Germany.
| |
Collapse
|
47
|
Abstract
Folic acid supplementation has drawn much attention in recent years for the prevention of Alzheimer's disease and cognitive decline. In this review, the authors describe how current evidence does not support the use of folic acid supplements to protect against cognitive decline. Although a few studies suggest that folic acid supplementation may provide neuroprotection among persons who are folate deficient, there is also data to indicate that supplementation in persons without folate deficiency may pose a risk to neurological function. Vitamin B12 deficiency is common in old age and may not be easy to recognise. Folic acid supplementation may mask the anaemia associated with vitamin B12 deficiency and, therefore, may delay treatment while allowing progression of neurological symptoms. Whether or not folic acid supplementation exacerbates neurological symptoms of vitamin B12 deficiency is not clear. Further studies are needed to determine the possible risks and benefits of folic acid supplementation in older persons.
Collapse
Affiliation(s)
- Julie A Schneider
- Rush University Medical Center, Rush Alzheimer's Disease Center and Department of Neurological Sciences, 600 S. Paulina St., Suite 1022F, Chicago, IL 60612, USA.
| | | | | |
Collapse
|
48
|
Berr C, Akbaraly TN, Nourashemi F, Andrieu S. Épidémiologie des démences. Presse Med 2007; 36:1431-41. [PMID: 17560760 DOI: 10.1016/j.lpm.2007.04.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Accepted: 04/17/2007] [Indexed: 11/29/2022] Open
Abstract
Dementia is a major public health problem and its burden will increase in the 30 years to come. Prevalence increases with age and incidence is slightly higher in women than men, especially after the age of 80 years. Survival after the onset of dementia is approximately 5 years. Lifestyle and health habits are a keystone for dementia: risk factors include physical, intellectual and social activity and nutritional habits. Data from well-conducted intervention studies are necessary to show whether better care for hypertension, diabetes, and dyslipidemia might decrease the incidence of dementia.
Collapse
Affiliation(s)
- Claudine Berr
- Inserm, U888, Université Montpellier 1, Montpellier (34).
| | | | | | | |
Collapse
|
49
|
Elias JW, Wagster MV. Developing context and background underlying cognitive intervention/training studies in older populations. J Gerontol B Psychol Sci Soc Sci 2007; 62 Spec No 1:5-10. [PMID: 17565160 DOI: 10.1093/geronb/62.special_issue_1.5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Underlying the attempt to change behavior or improve performance by virtue of intervention or training is the notion that change is possible and that plasticity, life-course malleability, and compensation are well-recognized concepts of life-span development. The cognition and aging literature reveals that there are a growing number of context and background variables against which the effectiveness of intervention/training can be judged beyond the intrinsic motivations for change. In this introductory article to a special issue on cognitive intervention and training, we briefly discuss several of these background variables.
Collapse
Affiliation(s)
- Jeffrey W Elias
- National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA.
| | | |
Collapse
|
50
|
Abstract
OBJECTIVE Physicians often check folate and cobalamin levels in patients with schizophrenia and depression. The reasons for this practice are reviewed, as well as implications for treatment. METHOD The physiology of the one-carbon cycle, involving folate, cobalamin, homocysteine, S-adenosyl-methionine, and methylene tetrahydrofolate reductase (MTHFR) is first reviewed, and then the particular contributions of folate and B12 are reviewed. PubMed was searched for studies of the association between folate, cobalamin, homocysteine, and MTHFR polymorphisms and schizophrenia and depression. RESULTS The recent key studies from the large literature addressing these topics are summarized. Treatment implications are discussed. CONCLUSION It is important to check folate and B12 levels in certain situations, such as alcoholism, malnutrition, malabsorption, and the concurrent use of some medications. Checking homocysteine and methylmalonic levels might be useful. With respect to treatment, folate and cobalamin deficiencies should be corrected. Cobalamin supplementation is probably not helpful. Folate supplementation is indicated in pregnancy but may exacerbate the effects of cobalamin deficiency. SAMe may prove to be a useful antidepressant. In the future, screening for MTHFR polymorphisms might be useful.
Collapse
Affiliation(s)
- Frances Rachel Frankenburg
- Department of Psychiatry, Harvard Medical School, and Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA.
| |
Collapse
|