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Elevated plasma homocysteine level in vascular dementia reflects the vascular disease process

Karin Nilsson1, Lars Gustafson, Björn Hultberg

  • 1Department of Psychogeriatrics, Clinical Science, Lund University Hospital, Lund, Sweden.

Dementia and Geriatric Cognitive Disorders Extra
|April 10, 2013
PubMed

Insights

Elevated plasma total homocysteine (tHcy) is common in vascular dementia (VaD). While partly due to vitamin deficiencies and kidney issues, high tHcy may specifically indicate vascular disease processes in VaD patients.

Area of Science:

  • Neurology
  • Biochemistry
  • Geriatrics

Background:

  • Patients with vascular dementia (VaD) show significantly higher plasma total homocysteine (tHcy) levels than those with other psychogeriatric conditions.
  • Elevated tHcy is a known risk factor for cerebrovascular and cardiovascular diseases.

Purpose of the Study:

  • To identify the primary determinants of plasma tHcy in patients with VaD.
  • To assess the specificity of elevated plasma tHcy in VaD by comparing with a depressed patient cohort.

Main Methods:

  • Investigated determinants of plasma tHcy in 525 VaD patients, including age, renal function, vitamin status (cobalamin/folate), and extracerebral vascular disease.
  • Utilized 270 patients with depression as a reference group.

Main Results:

  • Elevated plasma tHcy in VaD was only partially explained by cobalamin/folate deficiency or renal impairment.
  • Similar plasma tHcy levels in depressed patients with vascular disease and VaD patients suggest a link to the vascular disease process.

Conclusions:

  • Elevated plasma tHcy may serve as a sensitive biomarker for the vascular disease process in VaD.
  • Plasma tHcy levels reflect contributions from vitamin status, renal function, and vascular disease severity.
Abstract

Keywords:
CobalaminCreatinineDepressionFolateHomocysteineVascular dementiaVascular disease

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