Plasma homocysteine in relation to serum cobalamin and blood folate in a psychogeriatric population

Nilsson, Karin; Gustafson, Lars; Fäldt, R.; Andersson, Anders; Hultberg, Björn

doi:10.1111/j.1365-2362.1994.tb01111.x

Cited by 68 publications

(83 citation statements)

References 25 publications

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“…The relative risk for ischaemic stroke in those with a serum folate level less than 9.3 nmol/l was 1.37 [13]. The effectiveness of folic acid supplementation in reducing elevated homocysteine [ 14,15] suggests that consumption of this vitamin may be effective in reducing vascular risk.…”

Section: Introductionmentioning

confidence: 91%

“…Reports of metabolic dysfunction with even 'normal' serum folate levels [1,2,31], the declining efficiency of homocysteine metabolism associated with ageing [32] and the high prevalence of hyperhomocysteinemia [2] highlight the potential importance of folate nutrition. In this large study of elderly Canadians, there were non-significant correlations between low folate and a history of stroke and a history of intermittent claudication.…”

Section: Discussionmentioning

confidence: 99%

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Folate status, vascular disease and cognition in elderly Canadians

et al. 1998

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Objective: to report on the relationship between serum folate levels and the prevalence of stroke, peripheral vascular disease, cognitive problems and short-term mortality in elderly people. Setting and participants: 1171 subjects whose serum folate was determined as part of their clinical examination in the Canadian Study of Health and Aging, a population study of individuals 65 years and older. Methods: cross-sectional analysis compared relationships between serum folate levels and clinical features; longitudinal analysis examined mortality at follow-up by folate status at the time of the clinical examination. Results: membership in the lowest quartile for serum folate was associated with an increased likelihood of stroke. Those with low folate levels were more likely to be demented, institutionalized and depressed. In the cognitively impaired but not demented group, those with low folate levels scored lower on the Modified Mini Mental State and had more short-term memory problems. Conclusions: low folate level was a significant explanatory variable for stroke. Low folate levels were common in all types of dementia and were associated with a history of weight loss, lower body mass index and lower serum albumin concentrations. This may reflect the reduced ability of cognitively impaired individuals to eat adequately.

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Section: Introductionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Folate status, vascular disease and cognition in elderly Canadians

et al. 1998

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“…This method had a total CV of 4.4% and 2.0% at the levels of 10 and 36 M, respectively. The upper reference limit (95th percentile) for Hcy in a healthy elderly population (with normal cobalamin, folate, and creatinine) is 19.9 M. (21) Vitamin B 12 Serum vitamin B 12 was determined with the Elecsys Vitamin B 12 assay (Roche Diagnostics, Mannheim, Germany). This method had a total CV of 5.5% and 3.6% at 190 and 345 pM, respectively.…”

Section: Hcymentioning

confidence: 99%

Associations Between Homocysteine, Bone Turnover, BMD, Mortality, and Fracture Risk in Elderly Women

Gerdhem

Ivaska

Isaksson

et al. 2007

Journal of Bone and Mineral Research

106

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Homocysteine has been suggested to be a risk factor for fracture, but the causal relationship is not clear. In 996 women from the OPRA study, high homocysteine level was associated with high bone marker levels and low BMD at baseline. During a mean 7-year follow-up, high homocysteine level was associated with mortality, but no clear association to fracture risk existed.Introduction: Recently, the association between high serum homocysteine (Hcy) levels and an increased risk of fracture has been described. Materials and Methods: Hcy levels were measured at baseline in 996 women, all 75 years old. Vitamin B 12 , folate, serum cross-linking telopeptide of type I collagen (CTX), serum TRACP5b, serum osteocalcin, urine deoxypyridinoline, PTH, areal BMD (aBMD), calcaneal quantitative ultrasound (QUS), and physical performance were assessed at baseline. Fractures and mortality were recorded during a mean follow-up of 7.0 years. Results: Bone marker levels were higher in women with Hcy in the highest quartile compared with all other women (p < 0.05). The most evident correlation between Hcy and a bone marker was seen with CTX (r ‫ס‬ 0.19, p < 0.001). aBMD (hip) was 4% lower, QUS was up to 2% lower, and gait speed was 11% slower among women with Hcy in the highest quartile compared with the other women (p < 0.05). During the follow-up, 267 women sustained at least one low-energy fracture (including 69 hip fractures). When women in the highest Hcy quartile were compared with all other women, the hazard ratios (HRs) for sustaining any type of fracture was 1.18 (95% CI, 0.89-1.36) and for hip fracture was 1.50 (95% CI, 0.91-1.94). For the same group of women, the mortality risk was 2.16 (95% CI, 1.58-2.55). Adjustments for confounders did not substantially change these associations. Adjustment for PTH increased the HR for hip fracture to 1.67 (95% CI, 1.01-2.17). Low vitamin B 12 or folate was not associated with increased fracture risk or mortality. Conclusions: High Hcy levels were associated with higher bone turnover, poor physical performance, and lower BMD. There was no clear association to fracture risk. The increased mortality among women with high Hcy levels indicates that a high Hcy level may be a marker of frailty.

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“…The method has a coefficient of variation of 4%, calculated at the level of 15 Ìmol/l. The upper reference limit (95 percentile) for plasma homocysteine in an elderly population is 19.9 Ìmol/l [22].…”

Section: Assaysmentioning

confidence: 99%

“…Patients on any kind of ongoing vitamin substitution were excluded from the study. The clinical diagnosis was based on psychiatric, neurological, somatic and laboratory investigations, psychometric testing and brain imaging, such as measurements of regional cerebral blood flow, single photon emission tomography, electroencephalography, computed tomography scan and/or magnetic resonance imaging, as previously described [17,22,23]. AD was diagnosed in 122 cases (28 EOAD and 94 LOAD) and VaD was diagnosed in 57 cases.…”

Section: Study Populationmentioning

confidence: 99%

Relation between Plasma Homocysteine and Alzheimer’s Disease

Nilsson

Gustafson²,

Hultberg³

2002

Dement Geriatr Cogn Disord

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Objective: Several studies have shown that plasma total homocysteine (tHcy) concentration is elevated in Alzheimer’s disease (AD). However, it is not clear whether elevated plasma tHcy is a primary cause or a consequence of AD. Method: To elucidate this question, we have analysed plasma homocysteine and its determinants in patients with early (EOAD)- and late-onset AD (LOAD) and compared the findings with those in vascular dementia (VaD) and age- and sex-matched control subjects. Results: One of the main findings in the present study is that in EOAD there is no change in the levels of either plasma tHcy or its determinants compared with an age- and sex-matched control group. The fact that plasma tHcy concentration is normal in EOAD thus indicates that elevated plasma tHcy is not the primary cause of the disease. Another main finding is that patients with mixed dementia (AD and VaD) and patients with VaD showed significantly increased plasma tHcy concentration compared with controls and that plasma tHCy concentration in patients with LOAD and a history of additional cardiovascular disease was elevated compared both with AD patients without such a history and with the controls. Thus, there is an association between elevated plasma tHcy and vascular disease. A third main finding is that patients with AD who were followed up for several years showed a clinical deterioration of dementia and an elevation of plasma tHcy concentration. This finding likewise supports the notion that elevated plasma tHcy is not the primary cause of the disease. Conclusions: The findings suggest that elevated plasma tHcy is not the primary cause of the disease. Furthermore, the findings indicate that elevated plasma tHcy might be a reflection of concomitant vascular disease in AD patients.

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Plasma homocysteine in relation to serum cobalamin and blood folate in a psychogeriatric population

Abstract: Abstract. Plasma homocysteine, serum cobalamin and blood folate were analysed in 296

Cited by 68 publications

References 25 publications

Folate status, vascular disease and cognition in elderly Canadians

Folate status, vascular disease and cognition in elderly Canadians

Associations Between Homocysteine, Bone Turnover, BMD, Mortality, and Fracture Risk in Elderly Women

Relation between Plasma Homocysteine and Alzheimer’s Disease

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