Hyperhomocysteinaemia--a common finding in a psychogeriatric population

Area of Science:

• Geriatric Psychiatry
• Clinical Biochemistry
• Nutritional Neuroscience

Background:

• Plasma homocysteine is a sensitive indicator of cobalamin (vitamin B12) and folate deficiency.
• Psychogeriatric patients frequently exhibit elevated homocysteine, linked to neuropsychiatric symptoms and vitamin deficiencies.

Purpose of the Study:

• To investigate plasma homocysteine concentrations in a large cohort of psychogeriatric patients.
• To examine the correlation between homocysteine, cobalamin, folate, and creatinine levels.
• To explore potential genetic influences on homocysteine metabolism in this population.

Main Methods:

• Analysis of plasma homocysteine, blood folate, serum cobalamin, and serum creatinine in 741 psychogeriatric patients (295 demented, 215 non-demented).
• Comparison of patient groups with 163 healthy control subjects.
• Subgroup analysis based on vitamin levels and history of vascular disease.

Main Results:

• Significantly elevated plasma homocysteine was observed in both demented and non-demented psychogeriatric patients compared to controls.
• Demented patients showed lower blood folate and serum creatinine than controls.
• Even with adequate vitamin levels, patients had higher homocysteine, suggesting impaired homocysteine metabolism.
• Vascular dementia and history of arterial disease were associated with higher homocysteine.

Conclusions:

• Elevated plasma homocysteine is prevalent in psychogeriatric patients, irrespective of dementia status.
• Impaired homocysteine metabolism, potentially genetic, may contribute to higher levels in these patients.
• Homocysteine levels are linked to vascular health and cognitive status in the elderly psychiatric population.