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| 2. |
- Hultberg, Björn, et al.
(författare)
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Markers for the functional availability of cobalamin/folate and their association with neuropsychiatric symptoms in the elderly
- 2001
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 16:9, s. 873-878
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Tidskriftsartikel (refereegranskat)abstract
- Cobalamin/folate deficiency is common in elderly subjects and may lead to psychiatric symptoms, but even more often it increases the severity of other organic and non-organic mental diseases. This paper reviews the literature relevant for markers of cobalamin/folate status and their relation to neuropsychiatric symptoms in the elderly. Plasma homocysteine, a marker of cobalamin/folate status, is frequently increased in psychogeriatric patients. Among markers of cobalamin/folate status, plasma homocysteine shows the best association with neuropsychiatric dysfunction.
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| 3. |
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| 4. |
- Nilsson, Anna-Karin, et al.
(författare)
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C-reactive protein: vascular risk marker in elderly patients with mental illness.
- 2008
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 26:3, s. 251-256
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is increasing evidence that vascular disease contributes to cognitive impairment and dementia. Clarification of the role of vascular risk factors in dementia is important because most are modifiable, in contrast to other risk factors such as age and genetics. METHODS: In 428 patients with mental illness we have investigated the relation of vascular disease to diagnoses, and a biochemical parameter, C-reactive protein (CRP), which is associated with inflammation and vascular disease. RESULTS: Patients with vascular disease showed higher CRP levels than patients without vascular disease. Furthermore, patients with Alzheimer's disease showed lower CRP levels than patients with vascular dementia, mild cognitive impairment or depression. There is no obvious reason for this finding, since it could not be attributed to drug treatment. CONCLUSION: The findings indicate that the control of conventional vascular risk factors and therapy could be guided by the level of CRP.
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| 5. |
- Nilsson, Karin, et al.
(författare)
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Association between plasma homocysteine levels and mortality in elderly patients with mental illness.
- 2009
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 27:6, s. 579-583
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/METHOD: Total plasma homocysteine (tHcy) concentration is elevated in elderly patients with mental illness. Plasma tHcy is known to be associated with cardiovascular disease, renal impairment and negative lifestyle factors, and has been shown to predict mortality in human subjects. Epidemiological data on this topic in elderly patients with mental illness are missing. We therefore investigated the association between plasma tHcy levels and mortality in these patients. RESULTS: The group of deceased patients showed higher age, higher plasma tHcy, lower renal function and lower serum folate than patients who were still alive. Only age, plasma tHcy and the presence of vascular disease significantly influenced mortality. CONCLUSION: The association between plasma tHcy level and mortality risk was probably explained in part by the two plasma tHcy determinants age and presence of vascular disease. The determination of plasma tHcy in elderly patients with mental illness may help to identify patients in need of more intensive treatment.
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| 6. |
- Nilsson, Karin, et al.
(författare)
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Elevated plasma homocysteine concentration in elderly patients with mental illness is mainly related to the presence of vascular disease and not the diagnosis
- 2007
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 24:3, s. 162-168
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Tidskriftsartikel (refereegranskat)abstract
- Background: Plasma total homocysteine (tHcy) is often elevated in patients with mental illness. Since patients with mental illness and vascular disease exhibit a higher plasma tHcy concentration than patients without vascular disease, it is possible that elevated plasma tHcy in mental illness is mainly due to concomitant vascular disease. Methods: We have investigated plasma tHcy, cobalamin/folate status, renal function and the presence of vascular disease in patients with vascular dementia (VaD, n = 501), Alzheimer's disease ( AD, n = 300), depression ( n = 259) and in healthy subjects ( n = 144) stratified according to age ( below and above 75 years). Results: Plasma tHcy concentration showed the highest increase in patients with VaD compared to patients with AD or depression. After the exclusion of patients with cobalamin/ folate deficiencies and increased serum creatinine, patients with AD or depression above 75 years with vascular disease showed a similar elevation of plasma tHcy concentration as patients with VaD. Furthermore, patients with AD and depression without vascular disease showed a similar plasma tHcy concentration to healthy subjects. Conclusion: The findings imply that elevated plasma tHcy concentration in elderly patients with mental illness is mainly associated with the presence of vascular disease and is not related to the specific psychogeriatric diagnosis.
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| 7. |
- Nilsson, Karin, et al.
(författare)
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Elevated Plasma Homocysteine Level Is Not Primarily Related to Alzheimer's Disease.
- 2012
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 34:2, s. 121-127
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Tidskriftsartikel (refereegranskat)abstract
- Background: A moderate elevation of plasma total homocysteine (tHcy) is considered a potential risk factor for Alzheimer's disease (AD). Methods: We have investigated the main determinants (age, renal impairment, cobalamin/folate status and the presence of vascular disease) of plasma tHcy in 326 patients with AD, and also in 281 patients with mild cognitive impairment (MCI), since about half of these patients develop AD during the first 5 years. Results: Elevated plasma tHcy in patients with AD could mainly be attributed to cobalamin/folate deficiency or renal impairment. Younger patients (below 75 years) with AD and patients with MCI without cobalamin/folate deficiency or renal impairment showed normal levels of plasma tHcy. Conclusion: Our findings suggest that plasma tHcy is not primarily involved in the pathogenesis of AD but rather a reflection of changes of the main determinants of plasma tHcy in AD patients.
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| 8. |
- Nilsson, Karin, et al.
(författare)
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Homocysteine, cystatin C and N-terminal-pro brain natriuretic Peptide. Vascular risk markers in elderly patients with mental illness.
- 2008
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 25:1, s. 88-96
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is increasing evidence that vascular disease contributes to cognitive impairment and dementia. Clarification of the role of vascular risk factors in dementia is important because most are modifiable, in contrast to other risk factors such as age and genetics. METHODS: In 451 patients with mental illness we have investigated three biochemical markers related to vascular disease, total plasma homocysteine (tHcy), cystatin C, and N-terminal-pro brain natriuretic peptide (NT-proBNP), and their association with vascular disease, diagnoses, and brain imaging findings (CT). RESULTS: Plasma tHcy, serum cystatin C, and serum NT-proBNP showed significantly increased frequencies of elevated levels in patients with vascular disease, in patients with a pathological CT finding indicating cerebrovascular disease, and in patients above 75 years of age. CONCLUSION: It is possible that the control of conventional vascular risk factors and therapy could be guided by the level of plasma tHcy, serum cystatin C, and serum NT-proBNP. Patients with an elevation of any of these three parameters could be selected for a lower target level of risk factors such as blood pressure, hyperlipidemia etc. than conventional target levels.
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| 9. |
- Nilsson, Karin, et al.
(författare)
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Improvement of cognitive functions after cobalamin/folate supplementation in elderly patients with dementia and elevated plasma homocysteine
- 2001
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 16:6, s. 609-614
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the effect of cobalamin/folate supplementation on cognitive function in elderly patients with dementia. METHOD: The cobalamin/folate status of the patients was evaluated by measuring plasma homocysteine, serum methylmalonic acid, serum cobalamin and blood folate. Thirty-three patients were studied and repeatedly assessed with the Mini-Mental State Examination (MMSE) and 'A short cognitive performance test for assessing memory and attention' (SKT) during vitamin substitution. RESULTS: Patients with mild-moderate dementia and elevated plasma homocysteine levels improved clinically with increased test scores after vitamin substitution, while severely demented patients and patients with normal plasma homocysteine levels did not improve clinically. CONCLUSIONS: Plasma homocysteine may be the best marker for detecting treatable cobalamin/folate deficiency in patients with dementia.
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| 10. |
- Nilsson, K, et al.
(författare)
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Lack of association between plasma homocysteine and inflammation in psychogeriatric patients
- 2002
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Ingår i: Dementia and Geriatric Cognitive Disorders. - 1420-8008. ; 14:3, s. 151-155
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives: In previous studies we observed a high incidence of elevated plasma homocysteine (tHcy) concentrations in psychogeriatric patients. Plasma tHcy is increased in folate deficiency. Folates are sensitive to oxidative stress. Oxidative stress, caused by inflammatory processes, could represent an endogenous reason for folate deficiency, even when the dietary intake of the vitamin is within the recommended range. It has been suggested that oxidative stress rather than insufficient folate intake causes hyperhomocysteinemia in different forms of psychogeriatric diseases. In the present study we investigated the association between plasma tHcy and C-reactive protein (CRP), a sensitive marker for inflammation, in psychogeriatric patients. Methods: Plasma tHcy, its main determinants, and CRP were measured in plasma and serum of 132 psychogeriatric patients (53 males and 79 females, mean age 75 12 years). Results. In the psychogeriatric patients, plasma tHcy was elevated and blood folate and serum creatinine were lower than in control subjects, whereas serum CRP concentrations did not differ significantly. We also subdivided the psychogeriatric patients into different diagnosis groups, yet there were no differences in serum CRP concentrations in these groups compared with age-matched control groups. There was a significant correlation between plasma tHcy and serum CRP (rho = 0.19, p < 0.05). A stepwise multiple regression analysis including serum CRP, age, blood folate, serum cobalamin, serum methylmalonic acid and serum creatinine showed that only blood folate (p < 0.001), age (p < 0.001), serum creatinine (p < 0.001), serum cobalamin (p < 0.001), and serum methylmalonic acid (p < 0.001) independently predicted plasma tHcy concentration. Thus CRP concentration was not an independent predictor of plasma tHcy. Conclusion: The present study did not show any association between inflammatory status and plasma tHcy concentration in psychogeriatric patients.
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