| 1. |
- Nilsson, Karin, et al.
(författare)
-
Plasma Homocysteine and Cognition in Elderly Patients with Dementia or Other Psychogeriatric Diseases.
- 2010
-
Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 30:3, s. 198-204
-
Tidskriftsartikel (refereegranskat)abstract
- 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. Method: 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%). Conclusion: 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.
|
|
| 2. |
- Nilsson, Karin, et al.
(författare)
-
Plasma homocysteine, apolipoprotein E status and vascular disease in elderly patients with mental illness.
- 2010
-
Ingår i: Clinical Chemistry and Laboratory Medicine. - 1437-4331. ; 48:1, s. 129-135
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: Total plasma homocysteine (tHcy) concentration is increased in elderly patients with mental illness. Also, patients with vascular disease have significantly higher plasma tHcy concentration compared with patients without vascular disease. Apolipoprotein E (apoE) status is associated with cardiovascular disease and a major genetic risk factor is inheritance of the e4 allele. In the present study, we investigated the association between plasma tHcy and apoE status. Methods: The relation between apoE status, plasma tHcy and vascular disease was investigated in a cohort of consecutively enrolled elderly patients with mental illness (n=328). Results: Plasma tHcy concentrations were increased (p<0.01) in carriers of APOE4 (13.6 mumol/L; 9.2-21.7 mumol/L) compared to non-carriers (12.4 mumol/L; 8.3-19.9 mumol/L). The proportion of patients with vascular disease was significantly (p<0.001) increased among carriers (61%) compared to non-carriers (42%). An increased percentage (p<0.001) of APOE4 carriers was observed in patients with Alzheimer's disease (AD) with (71%) or without vascular disease (42%), and in patients with vascular dementia (VaD) (54%) compared to a reference group (34%). Conclusions: Since carriers of APOE4 showed an increased likelihood of vascular disease, these patients need more intensive control of other modifiable vascular risk factors. Furthermore, the association between plasma tHcy and the presence of APOE4 might be attributed to an increased proportion of vascular disease in APOE4 carriers. Clin Chem Lab Med 2010;48.
|
|
| 3. |
- Nilsson, Karin, et al.
(författare)
-
Survival in a large elderly population of patients with dementia and other forms of psychogeriatric diseases.
- 2011
-
Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 32:5, s. 342-350
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Dementia and other psychogeriatric diseases in elderly patients bring an increased risk of death. Better knowledge of prognosis in elderly patients affected by dementia or mental illness should be of great importance in order to improve care plans and assist in medical decisions. Methods: We have investigated the survival time in 2,112 patients with dementia and other forms of psychogeriatric diseases, enrolled during 1990 to 2005 and followed up until 2009, and the influence of diagnoses, plasma homocysteine level, presence of vascular disease and renal impairment. Results: The survival time after diagnosis in most diagnostic groups is about a third compared to an average population of similar age and sex. Age was the main predictor of survival time in all patients. Conclusions: All diagnoses, except in patients with subjective cognitive impairments, showed an increased mortality. These estimates can be used for prognosis and planning for patients, carers, service providers and policy makers.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Nilsson, Karin, et al.
(författare)
-
The use of N-terminal pro-brain natriuretic Peptide to evaluate vascular disease in elderly patients with mental illness.
- 2012
-
Ingår i: Dementia and Geriatric Cognitive Disorders Extra. - : S. Karger AG. - 1664-5464. ; 2, s. 10-18
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) is regarded as a sensitive marker of cardiovascular disease. Vascular disease plays an important role in cognitive impairment. METHOD: In 447 elderly patients with mental illness, serum NT-proBNP level and the presence or absence of vascular disease according to the medical record were used to categorize patients in different subgroups of vascular disease. RESULTS AND CONCLUSION: Patients with vascular disease and elevated serum NT-proBNP level had a lower cognition level, shorter survival time, lower renal function and a higher percentage of pathological brain imaging than patients with vascular disease and normal NT-proBNP level. Thus, elevated serum NT-proBNP level might be helpful to detect patients who have a more severe cardiovascular disease.
|
|
| 7. |
- Nilsson, Karin, et al.
(författare)
-
Elevated Plasma Homocysteine Level Is Not Primarily Related to Alzheimer's Disease.
- 2012
-
Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 34:2, s. 121-127
-
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.
|
|
| 8. |
|
|
| 9. |
- Nilsson, Karin, et al.
(författare)
-
Plasma homocysteine, brain imaging and cognition in older patients with mental illness.
- 2012
-
Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 27, s. 409-414
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Total plasma homocysteine (tHcy) concentration is elevated in older patients with mental illness, and patients with vascular disease have higher plasma tHcy concentration than patients without vascular disease. Plasma tHcy has been reported to be associated with cognitive functions. The mechanism by which plasma tHcy may influence cognitive functions is not clear. METHOD: We have investigated the relation between plasma tHcy, brain imaging findings (computer tomography scan [CT]) and cognition, measured as Mini mental state examination (MMSE), in 395 consecutively enrolled older patients with mental illness. RESULTS: Age and plasma tHcy were significant predictors of MMSE score, whereas pathological CT findings, indicating cerebrovascular disease, showed no prediction of MMSE score. CONCLUSION: The relation between plasma tHcy and cognition is not mediated by cerebrovascular disease as evaluated by pathological CT findings. Copyright © 2011 John Wiley & Sons, Ltd.
|
|
