Plasma folate levels in relation to cognitive impairment: a community-based cohort of older adults in China

doi:10.1007/s00394-022-02825-y

. 2022 Aug;61(5):2837-2845.

doi: 10.1007/s00394-022-02825-y. Epub 2022 Mar 18.

Plasma folate levels in relation to cognitive impairment: a community-based cohort of older adults in China

Xiao Chen¹, Jiaxi Yang^{2

3}, Hui Zhang^{4

5}, Yuhui Huang¹, Yaying Cao⁶, Shiyu Yan¹, Geng Zong⁶, Yan Zheng⁷, Xiaofeng Wang^{8

9}, Changzheng Yuan^{10

11}

Affiliations

¹ School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
² Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
³ Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁴ Human Phenome Institute, Fudan University, Shanghai, China.
⁵ National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
⁶ CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China.
⁷ State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China.
⁸ Human Phenome Institute, Fudan University, Shanghai, China. wangxiaofeng@fudan.edu.cn.
⁹ National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. wangxiaofeng@fudan.edu.cn.
¹⁰ School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. chy478@zju.edu.cn.
¹¹ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. chy478@zju.edu.cn.

PMID: 35303753
DOI: 10.1007/s00394-022-02825-y

Plasma folate levels in relation to cognitive impairment: a community-based cohort of older adults in China

Xiao Chen et al. Eur J Nutr. 2022 Aug.

. 2022 Aug;61(5):2837-2845.

doi: 10.1007/s00394-022-02825-y. Epub 2022 Mar 18.

Authors

Xiao Chen¹, Jiaxi Yang^{2

3}, Hui Zhang^{4

5}, Yuhui Huang¹, Yaying Cao⁶, Shiyu Yan¹, Geng Zong⁶, Yan Zheng⁷, Xiaofeng Wang^{8

9}, Changzheng Yuan^{10

11}

Affiliations

¹ School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
² Bia-Echo Asia Centre for Reproductive Longevity & Equality (ACRLE), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
³ Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁴ Human Phenome Institute, Fudan University, Shanghai, China.
⁵ National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
⁶ CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China.
⁷ State Key Laboratory of Genetic Engineering, Human Phenome Institute, and School of Life Sciences, Fudan University, Shanghai, China.
⁸ Human Phenome Institute, Fudan University, Shanghai, China. wangxiaofeng@fudan.edu.cn.
⁹ National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. wangxiaofeng@fudan.edu.cn.
¹⁰ School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. chy478@zju.edu.cn.
¹¹ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. chy478@zju.edu.cn.

PMID: 35303753
DOI: 10.1007/s00394-022-02825-y

Abstract

Purpose: Lower plasma level of folate has been associated with an increased risk of age-related cognitive impairment. However, studies that examined this relation have yielded mixed results. We aimed to examine the prospective association of plasma folate level with risk of cognitive impairment in a community-based prospective cohort of older adults in China.

Methods: This study included 615 participants (mean age: 76.3 years) without baseline cognitive impairment from the Rugao Longevity and Ageing Study (RuLAS). We used logistic regression to examine the prospective association between baseline plasma folate and risk of cognitive impairment in the next two years. Fasting blood samples were collected and assayed for plasma folate level at baseline. Cognitive impairment was defined as Hasegawa Dementia Scale (HDS) score ≤ 21.5 points.

Results: During two years' follow-up, 20.7% of the participants developed cognitive impairment. After controlled for age, gender, and plasma homocysteine, a higher level of plasma folate was associated with lower odds of cognitive impairment. The corresponding odds ratio (OR) with 95% confidence interval was 0.41 (0.19-0.89) comparing participants at extreme quintiles of plasma folate (median level 17.2 vs. 6.3 nmol/L). The associations were similar after further adjustment for major demographic and lifestyle factors (OR = 0.42, 0.18-0.98). Moreover, the inverse association was particularly stronger among males (OR = 0.12, 0.03-0.52) but was non-significant among females.

Conclusion: Our findings support a potential beneficial role of higher plasma folate levels in cognitive function in older Chinese adults, particularly among males. Future studies with larger sample size and longer follow-up are warranted to confirm these findings and to identify the optimal plasma folate level for cognitive function.

Keywords: Chinese population; Cognitive function; Plasma folate level; Prospective study.

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Circulating metabolome in relation to cognitive impairment: a community-based cohort of older adults.
Huang Y, Sun X, Huang Q, Huang Q, Chen X, Zhou X, Chen H, Shen J, Gao M, Gong Y, Zhang H, Tang H, Wang X, Jiang X, Zheng Y, Yuan C. Huang Y, et al. Transl Psychiatry. 2024 Nov 11;14(1):469. doi: 10.1038/s41398-024-03147-9. Transl Psychiatry. 2024. PMID: 39528482 Free PMC article.

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[1] Wortmann M (2012) Dementia: a global health priority-highlights from an ADI and World Health Organization report. Alzheimer’s Res Ther 4(5):40. https://doi.org/10.1186/alzrt143 - DOI

[2] Wortmann M (2012) Dementia: a global health priority-highlights from an ADI and World Health Organization report. Alzheimer’s Res Ther 4(5):40. https://doi.org/10.1186/alzrt143 - DOI

[3] Wimo A, Jönsson L, Bond J, Prince M, Winblad B, International AD (2013) The worldwide economic impact of dementia 2010. Alzheimer’s Dement 9(1):1–11. https://doi.org/10.1016/j.jalz.2012.11.006 - DOI

[4] Wimo A, Jönsson L, Bond J, Prince M, Winblad B, International AD (2013) The worldwide economic impact of dementia 2010. Alzheimer’s Dement 9(1):1–11. https://doi.org/10.1016/j.jalz.2012.11.006 - DOI

[5] Alzheimer’s association (2016) 2016 Alzheimer’s disease facts and figures. Alzheimer’s Dement 12(4):459–509. https://doi.org/10.1016/j.jalz.2016.03.001 - DOI

[6] Alzheimer’s association (2016) 2016 Alzheimer’s disease facts and figures. Alzheimer’s Dement 12(4):459–509. https://doi.org/10.1016/j.jalz.2016.03.001 - DOI

[7] Morris MC (2016) Nutrition and risk of dementia: overview and methodological issues. Ann N Y Acad Sci 1367(1):31. https://doi.org/10.1111/nyas.13047 - DOI - PubMed - PMC

[8] Morris MC (2016) Nutrition and risk of dementia: overview and methodological issues. Ann N Y Acad Sci 1367(1):31. https://doi.org/10.1111/nyas.13047 - DOI - PubMed - PMC

[9] Smith P, Blumenthal J (2016) Dietary factors and cognitive decline. Journal Prev Alzheimer’s Dis 3(1):53. https://doi.org/10.14283/jpad.2015.71 - DOI

[10] Smith P, Blumenthal J (2016) Dietary factors and cognitive decline. Journal Prev Alzheimer’s Dis 3(1):53. https://doi.org/10.14283/jpad.2015.71 - DOI

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Plasma folate levels in relation to cognitive impairment: a community-based cohort of older adults in China

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Plasma folate levels in relation to cognitive impairment: a community-based cohort of older adults in China

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