%0 Journal Article %J J Alzheimers Dis %D 2021 %T The Association Between Homocysteine and Memory in Older Adults. %A Nelson, Monica E %A Andel, Ross %A Nedelska, Zuzana %A Martinkova, Julie %A Cechova, Katerina %A Marková, Hana %A Matuskova, Veronika %A Nikolai, Tomas %A Lerch, Ondřej %A Pařízková, Martina %A Laczó, Jan %A Vyhnálek, Martin %A Hort, Jakub %X

BACKGROUND: Identifying modifiable risk factors for cognitive decline can reduce burden of dementia.

OBJECTIVE: We examined whether homocysteine was associated with memory performance, mediated by entorhinal volume, hippocampal volume, total gray matter volume, or white matter lesions, and moderated by APOE ɛ4 allele, B vitamins, creatinine, total cholesterol, or triglycerides.

METHODS: All 204 members of the Czech Brain Aging Study with subjective cognitive decline (SCD; n = 60) or amnestic mild cognitive impairment (aMCI; n = 144) who had valid data were included. Linear regression was used, followed by conditional process modeling to examine mediation and moderation.

RESULTS: Controlling for age, sex, and education, higher homocysteine was related to poorer memory performance overall (b = -0.03, SE = 0.01, p = 0.017) and in participants with SCD (b = -0.06, SE = 0.03, p = 0.029), but less so in aMCI (b = -0.03, SE = 0.02, p = 0.074); though sensitivity analyses revealed a significant association when sample was reduced to aMCI patients with more complete cognitive data (who were also better functioning; b = -0.04, SE = 0.02, p = 0.022). Results were unchanged in fully adjusted models. Neither mediation by markers of brain integrity nor moderation by APOE ɛ4, B vitamins, creatinine, and cardiovascular factors were significant. Memory sub-analyses revealed that results for SCD were likely driven by non-verbal memory. The homocysteine-memory relationship was significant when hippocampal volume was below the median (b = -0.04, SE = 0.02, p = 0.046), but not at/above the median (p = 0.247).

CONCLUSION: Higher homocysteine levels may adversely influence memory performance, particularly in those without cognitive impairment. Results appear to be independent of brain health, suggesting that homocysteine may represent a good target for intervention.

%B J Alzheimers Dis %V 81 %P 413-426 %8 2021 May 04 %G eng %N 1 %R 10.3233/JAD-201558