title: Total serum homocysteine levels do not identify cognitive dysfunction in multimorbid elderly patients.
abstract: OBJECTIVE
  Total blood homocysteine (Hcys) and folate levels have been investigated in association with cognitive dysfunction in healthy but not in multimorbid elderly patients. We hypothesized that total serum Hcys is an adequate marker to identify multimorbid elderly patients with cognitive dysfunction assessed by the Short Cognitive Performance Test (SKT) and Mini-Mental State Examination (MMSE).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The study center was an acute geriatric hospital.
  
  
  METHODS
  A total of 189 multimorbid elderly patients were recruited.
  
  
  METHODS
  Cognitive dysfunction was determined according to the SKT and MMSE. Biochemical parameters (Hcys, folate, vitamin B12, hemoglobin), nutritional status (BMI, Mini Nutritional Assessment, nutritional intake), and activities of daily living were assessed.
  
  
  RESULTS
  According to the SKT, 25.4% of patients showed no cerebral cognitive dysfunction, 21.2% had suspected incipient cognitive dysfunction, 12.7% showed mild cognitive dysfunction, 9.0% had moderate cognitive dysfunction, and 31.7% of patients were demented. The median plasma Hcys value was elevated by approximately 20% in multimorbid elderly patients, independent of cognitive dysfunction. Serum folate and vitamin B12 concentrations were within normal ranges. We did not find significant differences in nutritional status, activities of daily living, numbers of diseases or medications, or selected biochemical parameters between the SKT groups.
  
  
  CONCLUSIONS
  Elevated serum Hcys levels with normal plasma folate and vitamin B12 concentrations were observed in multimorbid elderly patients. The plasma Hcys level did not appear to be an important biological risk factor for cognitive dysfunction in multimorbid geriatric patients.
authors.affiliation: Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Research Group on Geriatrics at Ev. Geriatriezentrum Berlin, Reinickendorfer Strasse 61, 13347 Berlin, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Hengstermann
authors.forename: G
authors.initials: G
authors.lastname: Laemmler
authors.forename: A
authors.initials: A
authors.lastname: Hanemann
authors.forename: A
authors.initials: A
authors.lastname: Schweter
authors.forename: E
authors.initials: E
authors.lastname: Steinhagen-Thiessen
authors.forename: A
authors.initials: A
authors.lastname: Lun
authors.forename: R-J
authors.initials: RJ
authors.lastname: Schulz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003072:Cognition Disorders / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D011581:Psychological Tests; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D006710:Homocysteine