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AlzRisk Paper Detail
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Reference: Kivipelto, 2009
Cohort: Kungsholmen Project
Risk Factor: Homocysteine


Exposure Detail
No further detail was provided about the plasma Hcy range, mean or median within each quartile.

"Total homocysteine was analyzed with a fluorescence polarisation immunoassay on an IMx® unit (Abbott Laboratories, IL, USA). At mean levels of 12.8 and 25.7 lM/l, intra-assay coefficients of variation (CV) were 1.3% and 2.1%, respectively. Inter-assay CV were 1.4% and 1.0%, respectively. Holo-TC was analyzed with a radioimmunoassay, HoloTC RIA (Axis-Shield, Dundee, Scotland). At mean levels of 34.5 and 98.8 pM/l intra-assay total CV were 6.6% and 6.0%, respectively. Inter-assay CV were 6.6% and 9.5%, respectively. These analyses were performed at the Department of Medical Biosciences, Umeå University Hospital, Umeaå, Sweden. All other biochemical analyses were performed using routine methods at the Laboratory of Clinical Chemistry, Karolinska Institutet, Stockholm, Sweden."

Ethnicity Detail
All participants were residents of the Kungsholmen district of Stockholm, Sweden. No other information was provided on the race or ethnicity of the participants.

Age Detail
"The study population included a sub-sample of 228 subjects, derived from the dementia-free cohort participating in the Kungsholmen Project (KP), a longitudinal population-based study on aging and dementia launched in 1987. The initial population included all registered inhabitants (n=2368) who were living in the Kungsholmen district of Stockholm and were aged 75 years and older [27]"

Screening and Diagnosis Detail
Screening Method:
DSM IIIR - dementiaDiagnostic and Statistical Manual III - Revised - dementia

AD Diagnosis:
DSM IIIR Diagnostic and Statistical Manual III-Revised

Total dementia definition: Dementia via DSM III-R.

"At baseline and each follow-up, physicians examined all subjects clinically according to a standardized protocol, trained personnel administered neuropsychological tests, and nurses collected data on family and personal history. Dementia and type of dementia were defined according to the Diagnostic and Statistical Manual of Mental Disorders criteria, revised 3rd edition [28]."

Covariates & Analysis Detail
Analysis Type:
Logistic regression

The article mentioned using Cox regression model in the "statistical analyses" section but listed logistic regression for results in Table 2.

"The associations between Hcy and holo-TC and the subsequent development of dementia and AD were analyzed using Cox regression analyses. Differences in follow-up time were taken into account in the analyses. The analyses were adjusted for age, sex and education (model 1), and then additionally for other potential confounding or mediating factors, including baseline BMI, albumin, hemoglobin, creatinine, ApoE e4 allele status (any ɛe4 allele vs. no ɛe allele) and mini-mental state examination (MMSE) score (model 2). Finally, we carried out analyses adjusting for holo-TC, B12 and folate in determining the tHcy-dementia association, and for Hcy and folate levels concerning the holo-TC-dementia association (model 3). The tHcy and holo-TC data were first analyzed as continuous variables and then grouped into quartiles. When studying whether the effect of tHcy on dementia/AD risk depended on holo-TC levels, stratified analyses were conducted using holo-TC mean values as a cut-off. The level of significance was <0.05 in all analyses."

AD Covariates:
Aage
Eeducation
Ggender
albuminalbumin
APOE234APOE e2 e3 e4 genotype
MMSEbaseline MMSE
BMIbody mass index
HGBhemoglobin
HTCholo-transcobalamin
CRTserum creatinine
FOLserum folate
VTBvitamin B12

TD Covariates:
Aage
Eeducation
Ggender
albuminalbumin
APOE234APOE e2 e3 e4 genotype
MMSEbaseline MMSE
BMIbody mass index
HGBhemoglobin
HTCholo-transcobalamin
CRTserum creatinine
FOLserum folate
VTBvitamin B12