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The Significance of Thyroid-Stimulating Hormone and Homocysteine in the Development of Alzheimer’s Disease in Mild Cognitive Impairment

A 6-Year Follow-up Study

Geriatric Section, Department of Clinical Neuroscience, Occupational Therapy and Elderly Care, Karolinska University Hospital, Stockholm, Sweden

Lars-Olof Wahlund, MD

Geriatric Section, Department of Clinical Neuroscience, Occupational Therapy and Elderly Care, Karolinska University Hospital, Stockholm, Sweden

Johan Lökk, MD

Geriatric Section, Department of Clinical Neuroscience, Occupational Therapy and Elderly Care, Karolinska University Hospital, Stockholm, Sweden, johan.lokk{at}karolinska.se

Mild cognitive impairment (MCI) represents a transition between normal aging and Alzheimer’s disease (AD). The aim of this study was to investigate the predictive value of vitamin B₁₂/folate, homocysteine, standard laboratory parameters, and concomitant diseases for development of AD in persons with an MCI diagnosis. Development of dementia was followed for 6 years in 93 consecutively recruited MCI persons. Information concerning the above factors was obtained from medical journals. Thirty-four percent of participants converted to AD within 6 years. A forward stepwise logistic regression was performed. The odds ratio (OR) for the Mini-Mental State Examination (MMSE) was 0.777; for age, 1.084; and for thyroid stimulating hormone (TSH), 0.287. The OR for homocysteine was 1.287 at 60 years of age and 1.087 at 65 years of age. Lower TSH levels together with the more established factors lower MMSE, higher homocysteine levels, and age were found to be predictive factors of AD. This may have clinical implications with regard to monitoring TSH levels and thyroxin substitution in MCI patients.

Key Words: MCI • Alzheimer’s disease • MMSE • homocysteine • TSH

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