Blood Concentrations of Homocysteine and Methylmalonic Acid among Demented and Non-Demented Swedish Elderly with and without Home Care Services and Vitamin B12 Prescriptions

Abstract

Background and Aims: Total plasma homocysteine (tHcy) has been suggested as a risk factor of dementia. Our aim was to investigate potential differences in tHcy status in relation to the prescription of vitamin B₁₂ and dementia diagnosis. We examined whether vitamin B₁₂ prescriptions, a family history of dementia, or the need for home care service might be associated with tHcy values. Methods: A cross-sectional monocenter study comprising 926 consecutive subjects attending our Memory Care Unit was conducted. Results: Demented subjects being prescribed vitamin B₁₂ had higher serum vitamin B₁₂ (p = 0.025) but also higher tHcy (p < 0.001) and serum methylmalonate (p = 0.032), and lower serum folate (p < 0.001) than those who did not receive vitamin B₁₂ prescriptions. tHcy levels were significantly higher in non-demented subjects receiving home care service (p = 0.007). This group also had lower serum albumin (dementia: p < 0.001; non-dementia: p = 0.004). There was no difference in renal function (estimated glomerular filtration rate) in demented or non-demented subjects with or without vitamin B₁₂ prescriptions (dementia with/without vitamin B₁₂ prescription: p = 0.561; non-dementia with/without vitamin B₁₂ prescription: p = 0.710). Conclusion: Despite vitamin B₁₂ prescriptions, demented subjects had higher tHcy and methylmalonate values. The elevated metabolite values could not be explained by differences in renal function. Thus, elderly subjects on vitamin B₁₂ prescription appear to have unmet nutritional needs.

Vitamin B12 Deficiency

“…26 The metabolism of methyl-melonyl acid (MMA) and homocystine involves cobolamin leads to raised level of these biomarkers in vitamin B12 deficient population. 27 In our study, the homocysteine and MMA level was not studied but this is an space of increasing interest presently. The literature reported the association between raised homocystine level and hypothyroidism that improves by making the patient as euthyroid case.…”

The nutritional care of people living with dementia at home: A scoping review

“…Increased dependency on the caregiver Regular monitoring of nutritional status Timely identification of malnutrition risk and regular monitoring Identification and measurement of nutritional status/risk (Annweiler et al, 2012;Bourdel-Marchasson et al, 2001;Buell et al, 2010;Burns et al, 1989;Chi et al, 2015;De Bruin et al, 2010;De Rouvray et al, 2014;Droogsma et al, 2013;Faxen Irving et al, 2009;Ferrario et al, 1996;Guerin et al, 2009;Guyonnet et al, 1998;Hagnelius, Wahlund, Schneede, & Nilsson, 2012;Ikeda et al, 2002;Keene & Hope, 1998;Kwan et al, 2005;Lyngroth et al, 2015;Milward et al, 1999;Presse et al, 2008;Rivière et al, 1998;Rivière et al, 2002;Salva et al, 2011;Scarmeas et al, 2009;Shatenstein, Kergoat, & Nadon, 2001;Shatenstein et al, 2007Shatenstein et al, , 2008Silva et al, 2013;Soto et al, 2012;Suominen et al, 2015;Tully et al, 2003;Vellas et al, 2005;Venci et al, 2015;Winograd et al, 1991) Nutritional status is a risk factor for institutional placement to use. The studies also suggested that nutritional status should be monitored regularly thereafter (Guerin et al, 2005;Isaia et al, 2011;…”