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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Homocysteine level and cognitive function in patients with arterial disease: the second manifestations of ARTerial

A Fleur van Raamt1, Sandra Kalmijn, Willem P Th M Mali

  • 1Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.

Journal of the American Geriatrics Society
|May 12, 2006
PubMed

Insights

Elevated total plasma homocysteine (tHcy) is linked to poorer cognitive function, including memory and attention, in individuals with arterial disease. This association appears independent of the extent and location of their vascular conditions.

Area of Science:

  • Neuroscience
  • Cardiovascular Medicine
  • Gerontology

Background:

  • Elevated total plasma homocysteine (tHcy) is a known risk factor for cardiovascular and cerebrovascular diseases.
  • Cognitive impairment is a common comorbidity in patients with manifest arterial disease.
  • The specific relationship between tHcy levels and cognitive function in this population requires further elucidation.

Purpose of the Study:

  • To investigate the association between total plasma homocysteine (tHcy) levels and cognitive function in patients diagnosed with manifest arterial disease.
  • To determine if this relationship is influenced by the extent or location of arterial disease.

Main Methods:

  • A cross-sectional study design was employed.
  • Three hundred forty-five patients with symptomatic cerebrovascular disease, cardiovascular disease, peripheral arterial disease, or abdominal aortic aneurysm were included.
  • Cognitive function was assessed using an extensive neuropsychological test battery covering memory, executive function, attention, and visuoperception, with results standardized into z-scores.

Main Results:

  • Linear regression analysis revealed a significant inverse relationship between elevated tHcy levels and global cognitive function.
  • Specifically, higher tHcy levels were associated with lower performance in memory, attention, and visuoperception and construction domains.
  • This association remained significant after adjusting for age, sex, educational level, extent, and location of atherosclerosis, and silent cerebral infarcts did not alter the findings.

Conclusions:

  • A significant relationship exists between total plasma homocysteine (tHcy) levels and cognitive function in patients with manifest arterial disease.
  • This association is independent of the extent and location of arterial disease, suggesting non-vascular mechanisms may be involved.
  • Further research is warranted to explore the underlying biological pathways connecting tHcy and cognitive decline in this patient group.
Abstract

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