Decreased serum homocysteine levels after micronutrient supplementation in older people

Main Article Content

Pusparini Pusparini

Abstract

Aging is associated with a gradual impairment in cognitive function. The elderly also show a high prevalence of undernutrition, whereas nutrition plays an important role in the metabolism of neuronal cells and enzymes. Homocysteine is an amino acid resulting from methionine metabolism and is dependent on intake of vitamin B12, vitamin B6 and folic acid. Homocysteine is said to play a role in cognitive function. The objective of this study was to evaluate the effect of micronutrient supplementation for 6 months on serum homocysteine levels and cognitive function in older people. This study was an experimental study of pre-post test design, carried out in Mampang subdistrict, South Jakarta. A total of 94 elderly people was recruited for this study, consisting of 44 females and 50 males. Serum homocysteine level was assessed by fluorescent polarization immunoassay and cognitive function by means of the mini mental state examination (MMSE) before and after micronutrient supplementation. Mean serum homocysteine concentration after supplementation decreased significantly to 14.8 ± 5.8 mmol/L, compared with mean serum homocysteine level of 15.9 ± 5.9 mmol/L before supplementation (p=0.000). Multiple regression analysis indicated that the factors influencing post-supplementation MMSE scores were gender (â=-0.350; p=0.000), education (â=0.510; p=0.000) and post-supplementation homocysteine levels (â=-0.201; p=0.000), while age, pre-supplementation homocysteine levels and BMI did not affect MMSE scores. Homocysteine concentration decreased significantly after 6 months of supplementation. The factors affecting post-supplementation MMSE scores were gender, level of education, and post-supplementation homocysteine level.

Article Details

How to Cite
Pusparini, P. (2016). Decreased serum homocysteine levels after micronutrient supplementation in older people. Universa Medicina, 29(3), 144–152. https://doi.org/10.18051/UnivMed.2010.v29.144-152
Section
Review Article

References

Weir DG, Molloy AM. Microvascular disease and dementia in the elderly: are they related to hyperhomocysteinemia? Am J Clin Nutr 2000;71: 859-60

Dufouil C, Alperovitch A, Ducros V, Tzourio C. Homocysteine, white matter hyperintensities, and cognition in healthy elderly people. Ann Neurol 2003;53:214-21.

Roberts S, Sternberg S. Do nutritional supplements improve cognitive function in the elderly? Nutr 2003;19:976-80.

Haan MN, Miller JW, Aiello AE, Whitmer RA, Jagust WJ, Mungas DM, et al. Homocysteine, B vitamins, and the incidence of dementia and cognitive impairment: result from the Sacramento area latino study on aging. Am J Clin Nutr 2007; 85:511-7.

Refsum H. Total homocystein. Guideline for determination on the clinical laboratory. Clinical laboratory news. AACC 2002;28:12-4.

Duel PB, Malinow MR. Homocystein: an important risk factor for atherosclerotic vascular disease. Curr Opin Lipidol 1997;8:28-34.

Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, A’Agostiono RB, et al. Plasma homocysteine as a risk factor for dementia and Alzheimer’s disease. N Engl J Med 2002;346: 476-83.

Mooijaart SP, Gussekloo J, Frolich M, Jolles J, Stott DJ, Westendorp RGJ. Homocysteine, vitamin B12 and folic acid and the risk of cognitive decline in old age: the Leiden 85-plus study. Am J Clin Nutr 2005;82:866-71.

Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, et al. Homocyteine and folate as risk factors for dementia and alzheimer disease. Am J Clin Nutr 2005;82:636-43.

Ueland PM, Refsum H, Stabler SP, Malinow MR, Anderson A, Allen RH. Total homocysteine in plasma or serum methods and clinical applications. Clin Chem 1993;39:1764-78.

Garcia A, Haron Y, Pulman K, Hua L, Freedman M. Increases in homocysteine are related to worsening of stroop scores in healthy elderly persons: a prospective follows up study. J Gerontol 2003;59A:1323-27.

Tucker KL, Qiao N, Scott T, Rosenberg I, Spiro A. High hmocysteine and low B vitamins predict cognitive decline in aging men: the veterans affairs normative aging study. Am J Clin Nutr 2005;82:627-35.

Garcia A, Zanibbi K. Homocysteine and cognitivie function in elderly people. CMAJ 2004;171:897-904.

Selhub J, Bagle LC, Miller J, Rosenberg IH. B vitamins, homocysteine, and neurocognitive function in the elderly. Am J Clin Nutr 2000; 71(suppl):4S-20S.

Quadri P, Fragiacomo C, Pezzati R, Zanda E, Forlani G, Tettamanti M, et al. Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and vascular dementia. Am J Clin Nutr 2004;80:114-22.

Miller JW, Green R, Ramos MI, Allen LH, Mungas DM, Jagust WJ, et al. Homocysteine and cognitive function in the Sacramento area latino study on aging. Am J Clin Nutr 2003;78:441-7.

Andres E, Loukili NH, Noel E, Kaltenbach G, Abdelgheni MB, Perrin AE, et al. Vitamin B12 (cobalamin) deficiency in elderly patients. CMAJ 2004;171:1503-55.

Stott DJ, MacIntoch G, Lowe GDO, Rumley A, Mcmahon AD, Langhorne P, et al. Randomized controlled trial of homocysteine lowering vitamin treatment in elderly patients with vascular disease. Am J Clin Nutr 2005;82:1320-6.

Lei F, Ng TP, Chuah L, Niti M, E HK. Homocysteine, folate, and vitamin B12 and cognitive performance in older chinese adult: findings from Singapore longitudinal ageing study. Am J Clin Nutr 2006;84:1506-12.

Chandra RK. Effect of vitamin and trace element supplementation on cognitive function in elderly subjects. Nutr 2001;17:709-12.

Wang Y, Zhang L, Moslehi R, Ma J, Pan K, Zhou T, et al. Long term garlic or micronutrient supplementation, but not anti-Helicobacter pylori therapy, increases serum folate or glutathione without affecting serum vitamin B12, or homocysteine in rural Chinese population. J Nutr 2009;139:106-12.

Nguyen P, Grajeda R, Melgar P, Markinkevage J, Flores R, Martorell R. Weekly may be as efficacious as daily folic acid supplementation in improving folate status and lowering serum homocysteine concentration in Guatemalan women. J Nutr 2008;138:1491-8.

Kruman II. Homocystein in elicits a DNA damage response in neuron that promotes apoptosis abd hypersensitivity to excitoxicity. J Neuroscience 2000;20:6920-6.

Hsu KK, Sorond FA, Jen HC, Hashmi A, Milberg WP, Lipsitz LA. The role of homocysteine in multisystem age related problems: a systematic review. J Gerontol 2005;60A:1190-201.

Massachusetts Medical Society. A controlled trial of homocysteine lowering and cognitive performance. N Engl J Med 2006;354:2764-72.

Miller JW. Assessing the association between vitamin B12 status and cognitive function in older adults. Am J Clin Nutr 2006;84:1259-60.

Krumdieck CL, Prince CW. Mechanisms of homocysteine toxicity on connective tissue: Implications for the morbidity of aging. J Nutr 2000;130:365S-8S.

Pusparini. Homocysteine and cognitive function in the elderly. Univ Med 2009;28:106-16.

Joosten E, Lesaffre E, Riezler R. Is metabolic evidence for vitamin B12 and folate deficiency more frequent in elderly patients with Alzheimer’s disease? J Gerontol A Biol Sci Med Sci 1997;52: M76-9.

Bell IR, Edman JS, Selhub J. Plasma homocysteine in vascular disease and in nonvascular dementia of depressed elderly people. Acta Psychiatr Scand 1992;86:386-90.

Borroni B, Agosti C, Panzali AF, Di Luca M, Padovani A. Homocysteine, vitamin B6, and vascular disease in patient with Alzheimer disease. Neurology 2002;59:1475-6.

Miller JW, Green R, Mungas DM, Reed BR, Jagust WJ. Homocysteine, vitamin B6, and vascular disease in Alzheimer disease. Neurology 2002;58:1471-5.