title: Blood Concentrations of Homocysteine and Methylmalonic Acid among Demented and Non-Demented Swedish Elderly with and without Home Care Services and Vitamin B(12) Prescriptions.
abstract: OBJECTIVE
  Total plasma homocysteine (tHcy) has been suggested as a risk factor of dementia. Our aim was to investigate potential differences in tHcy status in relation to the prescription of vitamin B(12) and dementia diagnosis. We examined whether vitamin B(12) prescriptions, a family history of dementia, or the need for home care service might be associated with tHcy values.
  
  
  METHODS
  A cross-sectional monocenter study comprising 926 consecutive subjects attending our Memory Care Unit was conducted.
  
  
  RESULTS
  Demented subjects being prescribed vitamin B(12) had higher serum vitamin B(12) (p = 0.025) but also higher tHcy (p < 0.001) and serum methylmalonate (p = 0.032), and lower serum folate (p < 0.001) than those who did not receive vitamin B(12) prescriptions. tHcy levels were significantly higher in non-demented subjects receiving home care service (p = 0.007). This group also had lower serum albumin (dementia: p < 0.001; non-dementia: p = 0.004). There was no difference in renal function (estimated glomerular filtration rate) in demented or non-demented subjects with or without vitamin B(12) prescriptions (dementia with/without vitamin B(12) prescription: p = 0.561; non-dementia with/without vitamin B(12) prescription: p = 0.710).
  
  
  CONCLUSIONS
  Despite vitamin B(12) prescriptions, demented subjects had higher tHcy and methylmalonate values. The elevated metabolite values could not be explained by differences in renal function. Thus, elderly subjects on vitamin B(12) prescription appear to have unmet nutritional needs.
authors.affiliation: Department of Geriatric Medicine, Örebro University Hospital, School of Health and Medical Sciences, Örebro University, Umeå, Sweden.
authors.forename: Nils-Olof
authors.initials: NO
authors.lastname: Hagnelius
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Wahlund
authors.forename: Jörn
authors.initials: J
authors.lastname: Schneede
authors.forename: Torbjörn K
authors.initials: TK
authors.lastname: Nilsson
keywords: Dementia; Folate; Home care service; Homocysteine; Vitamin B12