ABSTRACT Introduction: During the life cycle of individuals, interventions are essential to detect and reduce the risk and complications of chronic diseases. Objective: To determine the prevalence of vascular risk values of the main indicators of carbohydrate and lipid metabolism in adolescents and elderlies in Havana. Methods: A cross-sectional study was carried out with a sample made up of apparently healthy adolescents (469; aged 12-16 years) and elderlies (395 aged 65-100 years) without a diagnosis of diseases associated with marked alteration of nutritional and metabolic status. Both populations were evaluated regarding serum glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol using conventional enzymatic methods. Reference risk ranges were used. The results were analyzed using descriptive statistics. Results: In the evaluated adolescents, triglycerides (35.6%) and total cholesterol (23.9%) showed the highest frequencies of risk values. In females, both markers remained the highest in that aspect; while in males, glucose (25.5%) accounted second after triglycerides as the most altered indicators. In the elderlies, low-density lipoprotein cholesterol (58.2%) and total cholesterol (48.6%) corresponded to the highest frequencies of risk values, a pattern that was repeated in each sex. The average values of the indicators were markedly higher in the elderlies than in adolescents, except for glucose and high-density lipoprotein cholesterol. Conclusions: The results obtained show high prevalence of vascular risk values of several metabolic indicators evaluated in adolescents and elderlies, which suggests the need to monitor the analyzed indicators and implement interventions to modify such values, in view of reducing the associated risk, from stages early, such as the pre-adolescence stage.

RESUMEN Introducción: Durante el ciclo de vida de los individuos son imprescindibles intervenciones para detectar y reducir el riesgo y las complicaciones de las enfermedades crónicas. Objetivo: Determinar la prevalencia de valores de riesgo vascular de los principales indicadores del metabolismo glucídico y lipídico en adolescentes y ancianos de La Habana. Métodos: Se realizó un estudio transversal en una muestra conformada por adolescentes (469 de 12-16 años) aparentemente sanos y ancianos (395 de 65-100 años) sin diagnóstico de enfermedades asociadas a la alteración marcada del estado nutricional y metabólico. Ambas poblaciones fueron evaluadas para glucosa, triglicéridos, colesterol total, colesterol de lipoproteinas de alta densidad y colesterol de lipoproteínas de baja densidad, séricos, mediante métodos enzimáticos convencionales. Se usaron rangos de riesgo referentes. Los resultados se analizaron mediante estadística descriptiva. Resultados: En los adolescentes evaluados, los triglicéridos (35,6 %) y el colesterol total (23,9 %) mostraron las mayores frecuencias de valores de riesgo. En las hembras ambos marcadores se mantuvieron como los más elevados en ese orden, mientras que, en los varones, la glucosa (25,5 %) secundó a los triglicéridos como indicadores más alterados. En ancianos, al colesterol de lipoproteínas de baja densidad (58,2 %) y al colesterol total (48,6 %) correspondieron las mayores frecuencias de cifras de riesgo, patrón que se repitió en cada sexo. Los valores promedio de los indicadores fueron marcadamente superiores en ancianos que, en adolescentes, excepto para glucosa y colesterol de lipoproteínas de alta densidad. Conclusiones: Los resultados obtenidos muestran una elevada prevalencia de valores de riesgo vascular de varios indicadores metabólicos evaluados en adolescentes y ancianos, lo que sugiere la necesidad de monitorear los indicadores analizados e implementar intervenciones modificadoras de sus valores hacia la reducción del riesgo asociado, desde etapas tempranas, como las previas a la adolescencia.

ABSTRACT Introduction: During the life cycle of individuals, interventions are essential to detect and reduce the risk and complications of chronic diseases. Objective: To determine the prevalence of vascular risk values of the main indicators of carbohydrate and lipid metabolism in adolescents and elderlies in Havana. Methods: A cross-sectional study was carried out with a sample made up of apparently healthy adolescents (469; aged 12-16 years) and elderlies (395 aged 65-100 years) without a diagnosis of diseases associated with marked alteration of nutritional and metabolic status. Both populations were evaluated regarding serum glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol using conventional enzymatic methods. Reference risk ranges were used. The results were analyzed using descriptive statistics. Results: In the evaluated adolescents, triglycerides (35.6%) and total cholesterol (23.9%) showed the highest frequencies of risk values. In females, both markers remained the highest in that aspect; while in males, glucose (25.5%) accounted second after triglycerides as the most altered indicators. In the elderlies, low-density lipoprotein cholesterol (58.2%) and total cholesterol (48.6%) corresponded to the highest frequencies of risk values, a pattern that was repeated in each sex. The average values of the indicators were markedly higher in the elderlies than in adolescents, except for glucose and high-density lipoprotein cholesterol. Conclusions: The results obtained show high prevalence of vascular risk values of several metabolic indicators evaluated in adolescents and elderlies, which suggests the need to monitor the analyzed indicators and implement interventions to modify such values, in view of reducing the associated risk, from stages early, such as the pre-adolescence stage.

RESUMEN Introducción: Durante el ciclo de vida de los individuos son imprescindibles intervenciones para detectar y reducir el riesgo y las complicaciones de las enfermedades crónicas. Objetivo: Determinar la prevalencia de valores de riesgo vascular de los principales indicadores del metabolismo glucídico y lipídico en adolescentes y ancianos de La Habana. Métodos: Se realizó un estudio transversal en una muestra conformada por adolescentes (469 de 12-16 años) aparentemente sanos y ancianos (395 de 65-100 años) sin diagnóstico de enfermedades asociadas a la alteración marcada del estado nutricional y metabólico. Ambas poblaciones fueron evaluadas para glucosa, triglicéridos, colesterol total, colesterol de lipoproteinas de alta densidad y colesterol de lipoproteínas de baja densidad, séricos, mediante métodos enzimáticos convencionales. Se usaron rangos de riesgo referentes. Los resultados se analizaron mediante estadística descriptiva. Resultados: En los adolescentes evaluados, los triglicéridos (35,6 %) y el colesterol total (23,9 %) mostraron las mayores frecuencias de valores de riesgo. En las hembras ambos marcadores se mantuvieron como los más elevados en ese orden, mientras que, en los varones, la glucosa (25,5 %) secundó a los triglicéridos como indicadores más alterados. En ancianos, al colesterol de lipoproteínas de baja densidad (58,2 %) y al colesterol total (48,6 %) correspondieron las mayores frecuencias de cifras de riesgo, patrón que se repitió en cada sexo. Los valores promedio de los indicadores fueron marcadamente superiores en ancianos que, en adolescentes, excepto para glucosa y colesterol de lipoproteínas de alta densidad. Conclusiones: Los resultados obtenidos muestran una elevada prevalencia de valores de riesgo vascular de varios indicadores metabólicos evaluados en adolescentes y ancianos, lo que sugiere la necesidad de monitorear los indicadores analizados e implementar intervenciones modificadoras de sus valores hacia la reducción del riesgo asociado, desde etapas tempranas, como las previas a la adolescencia.

ABSTRACT INTRODUCTION Age-related cognitive disorders, including Alzheimer disease, are among the main causes of disability and dependence in older adults worldwide. High blood homocysteine levels (hyperhomocysteinemia) are a risk factor for diseases whose metabolism involves different B vitamins. Antioxidant vitamins provide a protective effect by mitigating oxidative stress generated by these diseases. Epidemiological studies have presented varying results on the relationships between blood levels of these vitamins and such cognitive disorders. OBJECTIVE Evaluate the association of vitamin and homocysteine levels with mild cognitive impairment and Alzheimer disease in a group of Cuban older adults. METHODS A cross-sectional study was conducted in Havana, Cuba, of 424 persons aged ≥65 years: 43 with Alzheimer disease, 131 with mild cognitive impairment, and 250 with no signs of cognitive impairment. Dementia was diagnosed using criteria of the International 10/66 Dementia Research Group and Diagnostic and Statistical Manual of Mental Disorders (DSM IV), and mild cognitive impairment was diagnosed using Petersen’s criteria. Blood levels of vitamins (thiamine, B-2, folate, B-12, C and A) and homocysteine were measured by standard procedures. Analysis of variance for continuous variables and percentage comparison tests for dichotomous variables were used to compare groups. RESULTS Persons with Alzheimer disease presented significantly lower levels of vitamins B-2, C and A than healthy participants (p <0.05). Homocysteine levels were significantly higher in those with Alzheimer disease and mild cognitive impairment than in participants with no cognitive impairment (p <0.05). Statistically, levels of thiamine, folic acid, and vitamin B-12 were not significantly different across groups. Compared with those without cognitive impairment, prevalence rates (PR) in the Alzheimer group were significantly higher for hyperhomocysteinemia (PR = 3.26; 1.84–5.80) and deficiency of all B vitamins: thiamine (PR = 1.89; 1.04–3.43), B-2 (PR = 2.85; 1.54–5.26), folate (PR = 3.02; 1.53–5.95), B-12 (PR = 2.21; 1.17–4.19), vitamin C (PR = 3.88; 2.12–7.10) and A (PR = 5.47; 3.26–9.17). In mild cognitive impairment, prevalence rates were significantly higher for hyperhomocysteinemia (PR = 1.42; 1.08–1.87), vitamin B-2 deficiency (PR = 1.70; 1.24–2.32) and vitamin A deficiency (PR =1.88; 1.05–3.38). CONCLUSIONS Hyperhomocysteinemia and various vitamin deficiencies are related to Alzheimer disease and mild cognitive impairment. Longitudinal studies are needed to further elucidate the relationship between different nutritional biomarkers and dementia. A better understanding of this relationship could provide a basis for therapeutic and preventive strategies.

Many constituents of the diet from macronutrients to minerals exert influence on the brain's structure and function. Alzheimer's disease, a syndrome of cognitive deterioration, is a health problem in the geriatric population. Several studies have explored the role of diet in this disorder. Most of the results show that the high ingestion of unsaturated fatty acids, fish, vitamins B (B6, folate) and antioxidant vitamins (C,E) is associated with a low risk for the disease. In spite of the fact that not all these results are consistent, the possible etiological contribution of the nutritional factors should be considered in the prevention of this disease.

Muchos constituyentes de la dieta, desde los macronutrientes hasta los minerales, tienen influencia en la estructura y función del cerebro. La enfermedad de Alzheimer, síndrome de deterioro cognitivo, es un problema de salud en la población geriátrica. Diversos estudios han explorado el papel de la dieta sobre este trastorno. Los resultados muestran, en su mayoría, que la alta ingestión de ácidos grasos insaturados, pescado, vitaminas B (B6, folato) y vitaminas antioxidantes (C,E) está asociada a un bajo riesgo de la enfermedad. Aunque estos resultados no son consistentes en su totalidad la posible contribución etiológica de los factores nutricionales deben ser considerados en la prevención de esta enfermedad.

Many constituents of the diet from macronutrients to minerals exert influence on the brain's structure and function. Alzheimer's disease, a syndrome of cognitive deterioration, is a health problem in the geriatric population. Several studies have explored the role of diet in this disorder. Most of the results show that the high ingestion of unsaturated fatty acids, fish, vitamins B (B6, folate) and antioxidant vitamins (C,E) is associated with a low risk for the disease. In spite of the fact that not all these results are consistent, the possible etiological contribution of the nutritional factors should be considered in the prevention of this disease.

Muchos constituyentes de la dieta, desde los macronutrientes hasta los minerales, tienen influencia en la estructura y función del cerebro. La enfermedad de Alzheimer, síndrome de deterioro cognitivo, es un problema de salud en la población geriátrica. Diversos estudios han explorado el papel de la dieta sobre este trastorno. Los resultados muestran, en su mayoría, que la alta ingestión de ácidos grasos insaturados, pescado, vitaminas B (B6, folato) y vitaminas antioxidantes (C,E) está asociada a un bajo riesgo de la enfermedad. Aunque estos resultados no son consistentes en su totalidad la posible contribución etiológica de los factores nutricionales deben ser considerados en la prevención de esta enfermedad.

Neurocognitive impairments associated to dementia and particularly Alzheimer´s disease (AD) are reaching epidemic levels worldwide, being the cause of morbidity and of a high number of deaths in the elderly. Of the various risk factors of this disease, adequate nutrition seems to play a protective role. It is well known the essential function of some complex B vitamins in brain functioning. There are many epidemiological pieces of evidence in older people that show the association of low biochemical levels of intake of several vitamins with decline in cognitive abilities. Recent research studies suggest that hyperhomocysteinemia related to insufficient levels of some complex B vitamins may contribute to cognitive deterioration and to AD. Some studies show the role of vitamin B1 in the pathophysiology of AD. Because of their antioxidant role, vitamins A,E,C and carotene are considered as protectors against this disease. Vitamins have been used to treat cognitive deterioration and AD in a number of studies that demonstrate that vitamins are a factor to be taken into account in the prevention and treatment of Alzheimer's disease

Los trastornos neurocognitivos, asociados con demencias y dentro de éstos la enfermedad de Alzheimer (EA) están alcanzando proporciones epidémicas a nivel mundial, siendo causa de morbilidad y de un elevado número de muertes en individuos de la tercera edad. De los diversos factores de riesgo de la enfermedad, la nutrición adecuada parece jugar un papel protector. En los constituyentes de la dieta, es conocido el rol esencial de ciertas vitaminas del complejo B en la función del cerebro. Existen múltiples evidencias epidemiológicas en individuos de la tercera edad que han mostrado la asociación de los bajos niveles bioquímicos o ingestión de diversas vitaminas con la disminución de las habilidades cognitivas. Investigaciones recientes sugieren que la hiperhomocisteinemia asociada a inadecuados niveles de algunas vitaminas del complejo B puede contribuir al deterioro cognitivo y a la EA. Algunos estudios muestran el rol de la vitamina B1 en la fisiopatología de la EA. Las vitaminas: A, E, C y ß-caroteno, por su papel antioxidante, son consideradas como protectores de esta enfermedad. Las vitaminas han sido usadas para el tratamiento del deterioro cognitivo y la EA en diversos estudios. Estos estudios muestran que las vitaminas son un factor a tener en cuenta tanto en la prevención como en el tratamiento de la enfermedad