Psychiatry Investig.  2019 Jul;16(7):532-538. 10.30773/pi.2019.05.29.

Normal-But-Low Serum Folate Levels and the Risks for Cognitive Impairment

Affiliations
  • 1Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
  • 2Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. jwhanmd@snu.ac.kr
  • 3Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea.
  • 4Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea.
  • 5Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea.
  • 6Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Republic of Korea.
  • 7Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.
  • 8Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea.
  • 9Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Republic of Korea.
  • 10Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea.
  • 11Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea.
  • 12Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea.
  • 13Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea.
  • 14Department of Psychiatry, Bongseng Memorial Hospital, Busan, Republic of Korea.
  • 15Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • 16Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea.
  • 17Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea.
  • 18Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
  • 19Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
  • 20Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.

Abstract


OBJECTIVE
This study aimed to examine the association between normal-but-low folate levels and cognitive function in the elderly population using a prospective cohort study.
METHODS
We analyzed 3,910 participants whose serum folate levels were within the normal reference range (1.5-16.9 ng/mL) at baseline evaluation in the population-based prospective cohort study named the "Korean Longitudinal Study on Cognitive Aging and Dementia." The association between baseline folate quartile categories and baseline cognitive disorders [mild cognitive impairment (MCI) or dementia] was examined using binary logistic regression analysis adjusting for confounding variables. The risks of incident MCI and dementia associated with the decline of serum folate level during a 4-year follow-up period were examined using multinomial logistic regression analysis.
RESULTS
The lowest quartile group of serum folate (≥1.5, ≤5.9 ng/mL) showed a higher risk of cognitive disorders than did the highest quartile group at baseline evaluation (odds ratio 1.314, p=0.012). Over the 4 years of follow-up, the risk of incident dementia was 2.364 times higher among subjects whose serum folate levels declined from the 2nd-4th quartile group to the 1st quartile than among those for whom it did not (p=0.031).
CONCLUSION
Normal-but-low serum folate levels were associated with the risk of cognitive disorders in the elderly population, and a decline to normal-but-low serum folate levels was associated with incident dementia. Maintaining serum folate concentration above 5.9 ng/mL may be beneficial for cognitive status.

Keyword

Folate; Elderly; Cognition; Dementia; Cohort studies; Longitudinal studies

MeSH Terms

Aged
Cognition
Cognition Disorders*
Cognitive Aging
Cohort Studies
Confounding Factors (Epidemiology)
Dementia
Folic Acid*
Follow-Up Studies
Humans
Logistic Models
Longitudinal Studies
Prospective Studies
Reference Values
Folic Acid
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