Folate deficiency is a common finding in psychogeriatric patients.
OBJECTIVE
In previous studies we observed a high frequency of elevated total plasma homocysteine (tHcy) concentrations in psychogeriatric patients. The objective of the present study was to obtain detailed information on folate status in psychogeriatric patients and its association with elevated tHcy concentration.


METHODS
We measured serum and blood folate, tHcy, serum cobalamin, and serum methylmalonic acid in a study population consisting of 141 psychogeriatric patients, 49 of whom had elevated tHcy concentration.


RESULTS
The concentrations of serum and blood folate showed a high correlation and were significantly lower, and age significantly higher, in patients with elevated tHcy compared to patients with normal concentrations of tHcy. A stepwise multiple regression analysis including age, serum and blood folate, serum cobalamin, serum methylmalonic acid and serum creatinine showed that only serum creatinine (p<0.001), age (p<0.01), serum folate (p<0.05) and blood folate (p<0.05) independently predicted tHcy concentration. Only one patient of those with serum folate above 12 nmo/L had an elevated tHcy concentration. No such clear limit was observed for the relation between tHcy and blood folate. Thirty-two of the patients with elevated tHcy had decreased serum folate concentrations (<7.0 nmol/L), and seven of these patients also had signs of cobalamin deficiency. Ten patients had only signs of cobalamin deficiency.


CONCLUSIONS
Folate deficiency appears to be common in psychogeriatric patients, and serum folate seems to reflect folate deficiency better than blood folate. Our findings suggest the use of tHcy, serum cobalamin and serum folate to evaluate cobalamin-folate status in psychogeriatric patients.
Hultberg
Björn
B
Department of Laboratory Medicine, Division of Clinical Chemistry, University Hospital, Lund, Sweden. bjorn.hultberg@klinkem.lu.se
Nilsson
Karin
K
Isaksson
Anders
A
Gustafson
Lars
L
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders / Q000150:complications* / Q000378:metabolism*; D005260:Female; D005492:Folic Acid / Q000097:blood; D005494:Folic Acid Deficiency / Q000097:blood / Q000150:complications*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000175:diagnosis; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood; D012044:Regression Analysis; D014805:Vitamin B 12 / Q000097:blood
D006710:Homocysteine; D008764:Methylmalonic Acid; D005492:Folic Acid; D014805:Vitamin B 12