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From the Taub Institute for Research of Alzheimer’s Disease and the Aging Brain (Drs. Luchsinger, Tang, and Mayeux), the Divisions of Biostatistics (Dr. Tang) and Epidemiology (Drs. Shea and Mayeux), Joseph P. Mailman School of Public Health, and the Gertrude H. Sergievsky Center (Dr. Mayeux), Columbia University, New York; Division of General Medicine, Department of Medicine (Drs. Luchsinger and Shea), and Departments of Neurology and Psychiatry (Dr. Mayeux), Columbia University College of Physicians and Surgeons, New York, NY; and Department of Medical Pathology (Drs. Miller and Green), School of Medicine, University of California, Davis.
Address correspondence and reprint requests to Dr. Richard Mayeux, Gertrude H. Sergievsky Center, PH-19, 630 West 168th St., New York, NY 10032; e-mail: rpm2{at}columbia.edu
Objective: To explore the association between high homocysteine levels and risk of Alzheimer disease (AD) in the Washington Heights-Inwood Columbia Aging Project (WHICAP).
Methods: The authors obtained fasting plasma samples in 909 elderly subjects chosen at random from a cohort of Medicare recipients; there was longitudinal data in 679 subjects without dementia at baseline who were followed for 3,206 person-years. Prevalent and incident dementia and its subtypes were diagnosed using standard methods.
Results: There were 128 persons with prevalent AD and 109 with incident AD in 3,206 person-years of follow-up. The adjusted OR of prevalent AD for the highest quartile of homocysteine compared to the lowest was 1.3 (95% CI = 0.7, 2.3; p for trend = 0.25). In longitudinal analyses, the authors found that the adjusted hazard ratio of AD for the highest quartile of homocysteine was 1.4 (95% CI = 0.8, 2.4; p for trend = 0.31). The authors also found that high homocysteine levels were not related to a decline in memory scores over time. Age was a significant confounder in all the analyses. The study had 80% power to detect a hazard ratio of 1.3 in the longitudinal analyses.
Conclusion: High homocysteine levels were not associated with AD and were not related to a decrease in memory scores over time.
Received October 6, 2003. Accepted in final form January 29, 2004.
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