Serum homocysteine levels are correlated with behavioral and psychological symptoms of Alzheimer&amp;rsquo;s disease

Kim, Hyun; Lee, Kang Joon

doi:10.2147/ndt.s68980

Cited by 15 publications

(15 citation statements)

References 50 publications

(54 reference statements)

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“…Negative findings were reported by one study [25]. The results of this study are partially in accordance with the results of the study by Kim and Lee [27], which found significant correlation of plasma tHcy level with the total NPI score as well as with following NPI sub-domains: delusion, agitation/aggression, depression/dysphoria, elation/euphoria, apathy/indifference, and disinhibition. It is difficult to explain these differences, but the smaller sample size of our study (18 as compared to 77 AD patients of the study by Kim and Lee [27]) could be one possible reason for these differences.…”

Section: Discussionsupporting

confidence: 91%

“…Apart from this, the delusion; agitation/aggression, and depression/dysphoria sub-domains of NPI also showed significant correlation with homocysteine. Studies that have found association between homocysteine and BPSD are very few [26, 27]. Negative findings were reported by one study [25].…”

Section: Discussionmentioning

confidence: 99%

“…According to previous studies, though results are not consistent, it can be assumed that hyperhomocysteinemia may be correlated to schizophrenia like psychosis to some extent. Recently, Kim and Lee [27] found a positive correlation between the plasma tHcy level and delusion and agitation/aggression in AD patients. Various mechanisms have been suggested to explain the correlation between hyperhomocysteinemia and schizophrenia like psychosis.…”

Section: Discussionmentioning

confidence: 99%

“…Two previous studies have reported that the presence of major depressive disorders in patients with AD was correlated with hyperhomocysteinemia [27, 51]. Several studies have tried to identify the relationship between depression and homocysteine in elderly patients, but the results were not consistent [52-55].…”

Section: Discussionmentioning

confidence: 99%

“…The existing research is limited and only 3 studies with similar hypothesis were found. All of these studies have shown conflicting results [25-27]. So, on the basis of previous results suggesting that plasma homocysteine levels are associated with risk and symptoms of AD, the plasma homocysteine levels and BPSD in Indian AD patients were assessed and investigated to find any correlation between them.…”

Section: Introductionmentioning

confidence: 99%

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Serum Homocysteine and Behavioral and Psychological Symptoms of Dementia: Is There Any Correlation in Alzheimer’s Disease?

et al. 2018

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Background: There are studies showing the relation between serum B12, folate and Behavioral and Psychological symptoms of Dementia (BPSD) in Alzheimer’s disease (AD). Serum levels of these vitamins do not reflect actual disease status and therefore checking the serum Homocysteine level is considered a better test. Homocysteine has been found to be associated with cognitive impairment and various psychiatric disorders. Purpose: This study was planned to identify the correlation between serum homocysteine levels and BPSD in AD patients. Methods: AD patients (n = 18) and healthy controls (n = 18) were included in the study. Diagnosis of AD was confirmed using International Classification Disease-10. AD patients were assessed using Mini Mental Status Examination (MMSE), Clinical Dementia Rating scale (CDR), Global Deterioration scale (GDS), and Neuropsychiatric inventory (NPI). Healthy controls were assessed on MMSE and Mini International Neuropsychiatric Interview. Serum homocysteine, vitamin B12, and folate levels were measured in all study subjects. Results: Patients with AD had statistically significant higher serum levels of homocysteine as compared to the control group, while the levels of vitamin B12 and folate did not differ significantly. There was statistically significant positive correlation of serum homocysteine levels with total NPI score as well as with NPI sub-domains particularly delusion, agitation/aggression, and depression/dysphoria. Serum homocysteine levels did not correlate significantly with MMSE, CDR, and GDS scores. Conclusion: Correlation was observed between serum homocysteine levels and behavioral and psychological symptoms of AD. There is a possibility of etiological role, but the underlying pathophysiological mechanisms need to be elucidated. Whether patients will benefit or not with supplements of vitamin B12 and folate requires further research. This was a cross-sectional study and findings should not be generalized. Further prospective longitudinal studies with a large number of patients are needed.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum Homocysteine and Behavioral and Psychological Symptoms of Dementia: Is There Any Correlation in Alzheimer’s Disease?

et al. 2018

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Developing a predictive model for mortality in patients with cognitive impairment

Sugimoto,

Sakurai,

Noguchi

et al. 2023

Int J Geriat Psychiatry

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ObjectivesWe developed a predictive model for all‐cause mortality and examined the risk factors for cause‐specific mortality among people with cognitive impairment in a Japanese memory clinic‐based cohort (2010–2018).MethodsThis retrospective cohort study included people aged ≥65 years with mild cognitive impairment or dementia. The survival status was assessed based on the response of participants or their close relatives via a postal survey. Potential predictors including demographic and lifestyle‐related factors, functional status, and behavioral and psychological status were assessed at the first visit at the memory clinic. A backward stepwise Cox regression model was used to select predictors, and a predictive model was developed using a regression coefficient‐based scoring approach. The discrimination and calibration were assessed via Harrell's C‐statistic and a calibration plot, respectively.ResultsA total of 2610 patients aged ≥65 years (men, 38.3%) were analyzed. Over a mean follow‐up of 4.1 years, 544 patients (20.8%) died. Nine predictors were selected from the sociodemographic and clinical variables: age, sex, body mass index, gait performance, physical activity, and ability for instrumental activities of daily living, cognitive function, and self‐reported comorbidities (pulmonary disease and diabetes). The model showed good discrimination and calibration for 1–5‐year mortality (Harrell's C‐statistic, 0.739–0.779). Some predictors were specifically associated with cause‐specific mortality.ConclusionsThis predictive model has good discriminative ability for 1‐ to 5‐year mortality and can be easily implemented for people with mild cognitive impairment and all stages of dementia referred to a memory clinic.

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Epigallocatechin-3-gallate Enhances Cognitive and Memory Performance and Protects Against Brain Injury in Methionine-induced Hyperhomocysteinemia Through Interdependent Molecular Pathways

et al. 2022

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Brain injury and cognitive impairment are major health issues associated with neurodegenerative diseases in young and aged persons worldwide. Epigallocatechin-3-gallate (EGCG) was studied for its ability to protect against methionine (Met)-induced brain damage and cognitive dysfunction. Male mice were given Met-supplemented in drinking water to produce hyperhomocysteinemia (HHcy)-induced animals. EGCG was administered daily concurrently with Met by gavage. EGCG attenuated the rise in homocysteine levels in the plasma and the formation of amyloid-β and tau protein in the brain. Cognitive and memory impairment in HHcy-induced mice were significantly improved by EGCG administration. These results were associated with improvement in glutamate and gamma-aminobutyric acid levels in the brain. EGCG maintained the levels of glutathione and the activity of antioxidant enzymes in the brain. As a result of the reduction of oxidative stress, EGCG protected against DNA damage in Met-treated mice. Moreover, maintaining the redox balance significantly ameliorated neuroinflammation evidenced by the normalization of IL-1β, IL-6, tumor necrosis factor α, C-reactive protein, and IL-13 in the same animals. The decreases in both oxidative stress and inflammatory cytokines were significantly associated with upregulation of the antiapoptotic Bcl-2 protein and downregulation of the proapoptotic protein Bax, caspases 3 and 9, and p53 compared with Met-treated animals, indicating a diminution of neuronal apoptosis. These effects reflect and explain the improvement in histopathological alterations in the hippocampus of Met-treated mice. In conclusion, the beneficial effects of EGCG may be due to interconnecting pathways, including modulation of redox balance, amelioration of inflammation, and regulation of antiapoptotic proteins. Graphical Abstract

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Serum homocysteine levels are correlated with behavioral and psychological symptoms of Alzheimer’s disease

Cited by 15 publications

References 50 publications

Serum Homocysteine and Behavioral and Psychological Symptoms of Dementia: Is There Any Correlation in Alzheimer’s Disease?

Serum Homocysteine and Behavioral and Psychological Symptoms of Dementia: Is There Any Correlation in Alzheimer’s Disease?

Developing a predictive model for mortality in patients with cognitive impairment

Epigallocatechin-3-gallate Enhances Cognitive and Memory Performance and Protects Against Brain Injury in Methionine-induced Hyperhomocysteinemia Through Interdependent Molecular Pathways

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