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THE RELATIONSHIP BETWEEN HOMOCYSTEIN AND INCIDENT DEMENTIA IN ELDERLY AFRICAN AMERICANS AND ELDERLY NIGERIANS. From the Indianapolis – Ibadan Dementia Research Project. 27 TH ADI INTERNATIONAL CONFERENCE, London , March 7-10,2012. Introduction.
From the Indianapolis – Ibadan Dementia Research Project.
27TH ADI INTERNATIONAL CONFERENCE,
London , March 7-10,2012.
Current risk factors for dementia include, age, education, gait disorders, hypocampal atrophy, Apolipoprotein E allele and cardiovascular risk factors. Recently homocystein has been identified as a possible biomarker.
Homocystein blood levels are influenced by folic acid and Vitamin B group. It has been suggested that there is no real relationship, rather older persons (including the demented) may have lower vitamin levels in blood.
Cross-sectional studies fail to show relationship, but longitudinal studies show that high homocystein levels over time is related to incident dementia. Other studies show that treatment with folic acid and vitamin B lead to levels of homocystein and reduction in incident dementia, conversion of MCI to dementia and reduction of cognitive decline.
Only one study from South Africa (Delport 2000) has reported relationship between homocystein and dementia in Africa.
The project consisted of a screening phase, with the Community Screening Interview for Dementia (CSI-D). It also had a clinical assessment phase. Scores on the CSI-D were classified into good, intermediate and poor performance for selecting subjects for clinical assessment.
For Ibadan, subjects in the highest quartile of homocysteine had significantly higher risk of incident dementia comparing to those in the lowest quartiles (OR=3.7, 95% CI: 1.4-10.0). Folate and vitamin B12, although associated with homocysteine levels, were not independently associated with incident dementia in the final models including homocysteine level as an independent variable.
One of our expectations was that because of dietary differences, there may be differences in the mean serum levels of vitamins, and that probably leading to differences in the rates of dementia. However the information we have from our result is that higher levels of homocysteinein both populations is related to increased rate of dementia.
Table 1: Results of multiple logistic regression model with incident dementia as the outcome variable in the Indianapolis cohort.
OlusegunBaiyewu. Kathleen Lane.
AdesolaOgunniyi. Lisa Kamendulis.
OyeGureje. Fredrick Unverzagt.