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ORIGINAL RESEARCH article

Front. Med.

Sec. Geriatric Medicine

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1522531

This article is part of the Research TopicFrailty- and Age-Associated Diseases: Possibilities For Intervention (Volume 2)View all 11 articles

Associations between folate metabolism biomarkers and cognitive impairment in older Chinese adults: A cross-sectional study

Provisionally accepted
Huimin  LvHuimin LvJia  LiJia LiLu  ChenLu ChenKeyi  LuKeyi LuXudong  ZhaoXudong ZhaoMengyuan  GuoMengyuan Guo*Hailong  LuHailong Lu*
  • The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

The final, formatted version of the article will be published soon.

The role of folate metabolism-related biomarker profiles in age-related cognitive impairment (ARCI) remains unclear. This cross-sectional study aimed to examine the association between folate metabolism-related biomarkers and cognitive performance in older Chinese adults.We conducted a cross-sectional analysis of 100 participants aged between 56 and 87 years.Cognitive status was classified as ARCI if participants met the cutoff criteria on both the MMSE (<27) and MoCA (<26). Those meeting the cutoff criteria on both MMSE (≥27) and MoCA (≥26) were classified as cognitively normal (CN). Serum levels of folate metabolism-related biomarkers were compared between groups and analyzed for their associations with cognitive scores. Logistic regression was used to examine associations between individual biomarkers and cognitive impairment status. Multiple linear regression analyses were conducted to assess relationships with MMSE and MoCA scores, adjusting for age and education.Results: Cognitive impairment was prevalent among older adults at a rate of 56.3% (P < 0.05). The ARCI group showed significantly lower levels of vitamin B2 (VB2), folate (VB9) and lower MMSE and MoCA scores compared to the CN, while S-adenosylhomocysteine (SAH) and homocysteine (Hcy) levels were higher. MMSE and MoCA scores were positively correlated with serum VB2, VB9 and plasma Sadenosylmethionine (SAM) levels and negatively correlated with Hcy levels. Logistic regression showed that education and serum Hcy were significantly associated with cognitive impairment (AUC = 0.73). In addition to age, VB2, SAM and Hcy in the folate metabolic profile were significantly associated with MMSE and MoCA scores,accounting for 45.9% and 42.7% of the variance in these scores, respectively.Conclusions: VB2, SAM and Hcy may be associated with cognitive impairment in older Chinese adults and warrant further investigation as potential biomarkers.

Keywords: Vitamin B2, S-Adenosylmethionine, Homocysteine, folate metabolism, age-related cognitive impairment, cognitive impairment, Cross-sectional study

Received: 04 Nov 2024; Accepted: 24 Jul 2025.

Copyright: © 2025 Lv, Li, Chen, Lu, Zhao, Guo and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mengyuan Guo, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
Hailong Lu, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

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