Plasma homocysteine and cognition in elderly patients with dementia or other psychogeriatric diseases.
BACKGROUND
Total plasma homocysteine (tHcy) concentration is elevated in elderly patients with mental illness, and patients with vascular disease have higher plasma tHcy concentrations than patients without vascular disease. Increasing evidence indicates that vascular risk factors play a role in the development of cognitive impairment.


METHODS
We have investigated the relation between plasma tHcy, its determinants and cognition, measured as MMSE, in 448 consecutively enrolled patients with dementia or other psychogeriatric diseases.


RESULTS
Multiple regression analyses showed that plasma tHcy was related to cognitive function in all patients as well as in demented and non-demented patients. The apparent close relationship between plasma tHcy and cognition was mainly dependent on its determinant age, whereas the other determinants of plasma tHcy exhibited a limited influence on the relation between plasma tHcy and cognition. Plasma tHcy has its own, albeit modest, relationship to cognitive function (predictive value about 5%).


CONCLUSIONS
Plasma tHcy itself seems to play a minor role in cognitive impairment in patients with dementia or other psychogeriatric diseases. When investigating the relation between plasma tHcy and cognition, it is important to consider the distribution of the main determinants of plasma tHcy and to correct plasma tHcy for these variables.
Nilsson
Karin
K
Department of Psychogeriatrics, Clinical Science, Lund University Hospital, Lund, Sweden.
Gustafson
Lars
L
Hultberg
Björn
B
D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000097:blood; D003404:Creatinine / Q000097:blood; D003704:Dementia / Q000097:blood* / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000097:blood* / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000150:complications / Q000523:psychology; D014805:Vitamin B 12 / Q000097:blood
D006710:Homocysteine; D005492:Folic Acid; D003404:Creatinine; D014805:Vitamin B 12