Hyperhomocysteinaemia—a common finding in a psychogeriatric population

Abstract

Plasma homocysteine concentration is a sensitive marker for cobalamin and folate deficiency. The previously reported high incidence of increased plasma homocysteine in psychogeriatric patients and the association between reduced concentrations of cobalamin, folate and neuropsychiatric symptoms led to the present study on 741 consecutive psychogeriatric patients. The concentrations of plasma homocysteine correlated significantly with blood folate, serum cobalamin and serum creatinine both in demented (n = 295) and in non-demented patients with other psychiatric disorders (n = 215). Plasma homocysteine concentrations were significantly increased in both the demented and the non-demented patients, whereas only the demented patients had lower blood folate and serum creatinine concentrations than 163 control subjects. Almost all of the different diagnostic groups of demented and non-demented patients exhibited significantly increased plasma homocysteine concentrations compared with control subjects. Significantly decreased blood folate concentrations were mainly found in the different diagnosis groups of demented patients. Plasma homocysteine concentrations in both demented and non-demented patients with serum cobalamin and blood folate above the lower 20th percentile of these vitamins in the control subjects were also studied. Despite these vitamin concentrations, both groups of patients still exhibited significantly higher plasma homocysteine concentrations than the control subjects, which may indicate an increased frequency of impaired genetic capacity to metabolize homocysteine in these patients. Patients with either dementia of vascular cause or a history of other occlusive arterial disease had a significantly higher plasma homocysteine concentration than those without a history of vascular disease.

Pathogenicity of Thermolabile Methylenetetrahydrofolate Reductase for Vascular Dementia

“…Nilsson et al 22 reported a high prevalence of hyperhomocyst(e)inemia in psychogeriatric patients and suggested a possible genetic defect in demented patients with hyperhomocyst(e)inemia irrespective of folic acid depletion. Chapman et al 23 observed the lack of a significant association between the MTHFR genotype and vascular dementia, which was probably due to the insufficient number of the sample.…”

Serum Homocysteine in Relation to Mortality and Morbidity From Coronary Heart Disease

“…However, whether this is applicable to all vascular events remains to be shown. Interestingly, vitamin B 12 deficiency, folate deficiency, and hyperhomocysteinemia have more recently been linked to risk for development of dementia, [27][28][29] which may reflect its vascular etiology. In this context, tHcy analysis in everyday clinical practice appears preferable to both B 12 and folate analyses because it captures possible deficiencies in either or both of the vitamins, as well as being a risk factor for CVD.…”

Fibrinolysis and von Willebrand factor in Alzheimer's disease and vascular dementia – a case-referent study

“…From 1996-98 onwards, the hyperhomocysteinemic aspect of VaD (and AD) has attracted attention [33][34][35][36] An increase in hs-CRP may probably per se cause increased plasma tPA concentrations [29]. In our study we have shown ( Table 1) that hs-CRP is significantly lower in AD Table 2 were adjusted for hs-CRP.…”