Plasma Homocysteine Levels and Different Forms of Vascular Disease in Patients with Dementia and Other Psychogeriatric Diseases

BACKGROUND: Total plasma homocysteine (tHcy) concentration is elevated in patients with psychogeriatric disease. There are many different determinants of plasma tHcy concentration, including the presence of vascular disease. METHOD: We investigated plasma tHcy levels in several different subgroups of vascular disease and also the relation between plasma tHcy and renal function in patients with psychogeriatric disease. RESULTS: All different groups of patients with vascular disease exhibited an elevated level of plasma tHcy compared to patients without vascular disease even after exclusion of patients with folate/cobalamin deficiency. Patients with elevated serum creatinine with or without vascular disease exhibited significantly increased plasma tHcy compared to the respective groups of patients without elevated serum creatinine. Patients with vascular dementia and Alzheimer's disease with concomitant vascular disease exhibited significantly increased plasma tHcy levels compared to patients without vascular disease. CONCLUSION: The presence of vascular disease increases the level of plasma tHcy and renal impairment further increases the elevated plasma tHcy level. Furthermore, the findings suggest similar influence on plasma tHcy turnover irrespective of whether the vascular disease is of cerebral or extracerebral origin or only manifests itself as arrhythmia or hypertension.