Normal-But-Low Serum Folate Levels and the Risks for Cognitive Impairment
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Objective This study aimed to examine the association between normal-but-low folate levels and cognitive function in the elderly population using a prospective cohort study. Methods We analyzed 3,910 participants whose serum folate levels were within the normal reference range (1.5–16.9 ng/mL) at baseline evaluation in the population-based prospective cohort study named the “Korean Longitudinal Study on Cognitive Aging and Dementia.” The association between baseline folate quartile categories and baseline cognitive disorders [mild cognitive impairment (MCI) or dementia] was examined using binary logistic regression analysis adjusting for confounding variables. The risks of incident MCI and dementia associated with the decline of serum folate level during a 4-year follow-up period were examined using multinomial logistic regression analysis. Results The lowest quartile group of serum folate (≥1.5, ≤5.9 ng/mL) showed a higher risk of cognitive disorders than did the highest quartile group at baseline evaluation (odds ratio 1.314, p=0.012). Over the 4 years of follow-up, the risk of incident dementia was 2.364 times higher among subjects whose serum folate levels declined from the 2nd–4th quartile group to the 1st quartile than among those for whom it did not (p=0.031). Conclusion Normal-but-low serum folate levels were associated with the risk of cognitive disorders in the elderly population, and a decline to normal-but-low serum folate levels was associated with incident dementia. Maintaining serum folate concentration above 5.9 ng/mL may be beneficial for cognitive status.
Abstract
Objective This study aimed to examine the association between normal-but-low folate levels and cognitive function in the elderly population using a prospective cohort study. Methods We analyzed 3,910 participants whose serum folate levels were within the normal reference range (1.5–16.9 ng/mL) at baseline evaluation in the population-based prospective cohort study named the “Korean Longitudinal Study on Cognitive Aging and Dementia.” The association between baseline folate quartile categories and baseline cognitive disorders [mild cognitive impairment (MCI) or dementia] was examined using binary logistic regression analysis adjusting for confounding variables. The risks of incident MCI and dementia associated with the decline of serum folate level during a 4-year follow-up period were examined using multinomial logistic regression analysis. Results The lowest quartile group of serum folate (≥1.5, ≤5.9 ng/mL) showed a higher risk of cognitive disorders than did the highest quartile group at baseline evaluation (odds ratio 1.314, p=0.012). Over the 4 years of follow-up, the risk of incident dementia was 2.364 times higher among subjects whose serum folate levels declined from the 2nd–4th quartile group to the 1st quartile than among those for whom it did not (p=0.031). Conclusion Normal-but-low serum folate levels were associated with the risk of cognitive disorders in the elderly population, and a decline to normal-but-low serum folate levels was associated with incident dementia. Maintaining serum folate concentration above 5.9 ng/mL may be beneficial for cognitive status.
참고문헌 (34)
- Ferri CP, "Global prevalence of dementia : a Delphi consensus study", Lancet, 366, pp.2112~2117 (2005)
- Alzheimer’s Association, "2016 Alzheimer’s disease facts and figures", Alzheimers Dement, 12, pp.459~509 (2016)
- Petersen RC, "Mild cognitive impairment : a concept in evolution", J Intern Med, 275, pp.214~228 (2014)
- Roberts JS, "Estimating and disclosing the risk of developing Alzheimer’s disease : challenges, controversies and future directions", Future Neurol, 5, pp.501~517 (2010)
- Beydoun MA, "Epidemiologic studies of modifiable factors associated with cognition and dementia : systematic review and meta-analysis", BMC Public Health, 14, pp.643~ (2014)
- Brussaard JH, "Folate intake and status among adults in the Netherlands", Eur J Clin Nutr, 51(Suppl 3), pp.S46~S50 (1997)
- Reynolds E, "Vitamin B12, folic acid, and the nervous system", Lancet Neurol, 5, pp.949~960 (2006)
- Wald DS, "Homocysteine and cardiovascular disease : evidence on causality from a meta-analysis", BMJ, 325, pp.1202~ (2002)
- Shane B, "Vitamin B12-folate interrelationships", Annu Rev Nutr, 5, pp.115~141 (1985)
- Kumaravel TS, "Folic acid deficiency and homocysteine impair DNA repair in hippocampal neurons and sensitize them to amyloid toxicity in experimental models of Alzheimer’s disease", J Neurosci, 22, pp.1752~1762 (2002)
- Clarke R, "Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease", Arch Neurol, 55, pp.1449~1455 (1998)
- Quadri P, "Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and vascular dementia", Am J Clin Nutr, 80, pp.114~122 (2004)
- Kim JM, "Changes in folate, vitamin B12 and homocysteine associated with incident dementia", J Neurol Neurosurg Psychiatry, 79, pp.864~868 (2008)
- Ravaglia G, "Homocysteine and folate as risk factors for dementia and Alzheimer disease", Am J Clin Nutr, 82, pp.636~643 (2005)
- Shen L, "Associations between Homocysteine, Folic Acid, Vitamin B12 and Alzheimer’s Disease : Insights from Meta-Analyses", J Alzheimers Dis, 46, pp.777~790 (2015)
- Morris MC, "Dietary folate and vitamin B12 intake and cognitive decline among community-dwelling older persons", Arch Neurol, 62, pp.641~645 (2005)
- Hunter R, "Toxicity of folic acid given in pharmacological doses to healthy volunteers", Lancet, 1, pp.61~63 (1970)
- Ji Won Han, "Overview of the Korean Longitudinal Study on Cognitive Aging and Dementia", PSYCHIATRY INVESTIGATION, 15(8), pp.767~774 (2018), 대한신경정신의학회[DOI]
- Lee JH, "Development of the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet(CERAD-K) : clinical and neuropsychological assessment batteries", J Gerontol B Psychol Sci Soc Sci, 57, pp.P47~53 (2002)
- Lee DY, "A normative study of the CERAD neuropsychological assessment battery in the Korean elderly", J Int Neuropsychol Soc, 10, pp.72~81 (2004)
- Wechsler DA, "Wechsler Memory Scale-Revised" (1987), Psychological Corporation
- Kim TH, "Korean version of frontal assessment battery : psychometric properties and normative data", Dement Geriatr Cogn Disord, 29, pp.363~370 (2010)
- Tae Hui Kim, "Korean Version of Mini Mental Status Examination for Dementia Screening and Its Short Form", PSYCHIATRY INVESTIGATION, 7(2), pp.102~108 (2010), 대한신경정신의학회
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders: DSM-IV" (1994), American Psychiatric Association
- Winblad B, "Mild cognitive impairment--beyond controversies, towards a consensus : report of the International Working Group on Mild Cognitive Impairment", J Intern Med, 256, pp.240~246 (2004)
- Lho SK, "Effects of lifetime cumulative ginseng intake on cognitive function in late life", Alzheimers Res Ther, 10, pp.50~ (2018)
- Bae JN, "Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients", J Psychosom Res, 57, pp.297~305 (2004)
- Godoy A, "Prevalence of low folate deficiency after wheat flour supplementation - should we still measure serum folate?", Hematol Transfus Cell Ther, 40, pp.305~309 (2018)
- Theisen-Toupal J, "Low yield of outpatient serum folate testing : eleven years of experience", JAMA Intern Med, 174, pp.1696~1697 (2014)
- 김영남, "Folate food source, usual intake, and folate status in Korean adults", Nutrition Research and Practice, 12(1), pp.47~51 (2018), 한국영양학회
- Nurk E, "Plasma total homocysteine and memory in the elderly : the Hordaland Homocysteine Study", Ann Neurol, 58, pp.847~857 (2005)
- Morris MS, "The role of B vitamins in preventing and treating cognitive impairment and decline", Adv Nutr, 3, pp.801~812 (2012)
- Farkas M, "Hyperhomocysteinemia in Alzheimer’s disease: the hen and the egg?", J Alzheimers Dis, 33, pp.1097~1104 (2013)
- Petersen RC, "Mild cognitive impairment : clinical characterization and outcome", Arch Neurol, 56, pp.303~308 (1999)