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Homocysteine, depression and cognitive function in older adults
Andrew H Ford1, Leon Flicker2, Urvashnee Singh3
1Western Australian Centre for Health & Ageing (M573), Centre for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia; Department of Psychiatry, Royal Perth Hospital, 50 Murray Street, Perth, WA 6000, Australia.
Journal of Affective Disorders
|August 10, 2013
Summary
High total plasma homocysteine (tHcy) is linked to cognitive decline in older adults, even without major depression. Lowering homocysteine with B-vitamins may improve memory and cognitive function.
Area of Science:
- Gerontology
- Neuroscience
- Psychiatry
Background:
- Depression and elevated total plasma homocysteine (tHcy) are independently linked to cognitive impairment in older adults.
- This study investigated whether high tHcy mediates cognitive performance in older adults with major depression.
Purpose of the Study:
- To determine if high tHcy is a mediator of cognitive performance in older adults with major depression.
- To examine the association between tHcy levels and cognitive function across different depression statuses.
Main Methods:
- Recruited 358 community-dwelling older adults with depressive symptoms; 236 met major depression criteria.
- Assessed depression severity (MADRS), fasting tHcy, and cognitive function using a neuropsychological battery.
- Analyzed cognitive performance (MMSE, verbal/visual recall) in relation to tHcy levels and depression status.
Main Results:
- Individuals with major depression and high tHcy showed significantly worse immediate verbal and delayed visual recall.
- Non-depressed participants with high tHcy had lower MMSE and recall scores compared to those with normal tHcy.
- High tHcy nearly doubled the odds of cognitive inefficiency (MMSE, immediate/delayed recall) after adjustments.
Conclusions:
- Elevated tHcy correlates with poorer immediate/delayed memory and global cognitive performance, independent of major depression or symptom severity.
- Homocysteine-lowering B-vitamin supplementation presents a potential therapeutic strategy for cognitive deficits in this population.
- Study limitations include sub-syndromal symptoms in non-depressed participants and exclusion of those with established cognitive impairment.
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