Prevalence of hyperhomocysteinemia in Alzheimer’s disease and vascular dementia at outpatient unit in Ramathibodi hospital: Retrospective study
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Abstract
Objective: To study the prevalence and associated factors of hyperhomocysteinemia in Alzheimer’s disease and vascular dementia at outpatient unit at Ramathibodi hospital.
Method: This retrospective cross-sectional research was conducted with patients 65 years of age and older who were diagnosed with Alzheimer's disease or vascular dementia. Data which are based on electronic medical records from neurological department and psychiatric department at Ramathibodi hospital from 2015 to 2021, were collected including demographic data and serum homocysteine. Data were analyzed in terms of descriptive statistics, Chi-square test and independent t-test.
Results: This study included 67 Alzheimer's disease patients and 35 vascular dementia. The prevalence of hyperhomocysteinemia in patients with Alzheimer’s disease was 10.45%. The prevalence in patients with vascular dementia was 20.00%. Hyperhomocysteinemia was not statistically associated with age, gender, diabetes mellitus, hypertension, hyperlipidemia, history of smoking and alcohol consumption, plasma folate and vitamin B12 levels in our study.
Conclusion: The prevalence of hyperhomocysteinemia in patients with vascular dementia was higher than Alzheimer’s disease. Although this study found no statistically significant association between vascular risk factors and hyperhomocysteinemia, the effect of hyperhomocysteinemia and its treatment on cognitive function may be better understood by large longitudinal research.
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References
Foundation of Thai Gerontology Research and Development institute (TGRI). Situation of the Thai Older Persons 2020 [e-book]. Nakhon Pathom: Institute for Population and Social Research; 2021 [cited 2023 Dec 20]. Available from: https://www.dop.go.th/download/knowledge/th1635826412-975_0.pdf.
Chitapankul S, Suriyawongphaisarn P, Kunanuson C and Poolcharoen. Health problems of Thai elderly. Public Health Systems Research Institute; 1999
Rozzini L, Cornali C, Chilovi BV, Ghianda D, Padovani A, Trabucchi M. Predictors of institutionalization in demented patients discharged from a rehabilitation unit. Journal of the American Medical Directors Association 2006;7(6):345-9.
Etters L, Goodall D, Harrison BE. Caregiver burden among dementia patient caregivers: a review of the literature. Journal of the American Academy of Nurse Practitioners 2008;20(8):423-8.
El-Hayek YH, Wiley RE, Khoury CP, Daya RP, Ballard C, Evans AR, et al. Tip of the iceberg: assessing the global socioeconomic costs of Alzheimer’s disease and related dementias and strategic implications for stakeholders. Journal of Alzheimer's Disease 2019;70(2):323-41.
Brookmeyer R, Gray S, Kawas C. Projections of Alzheimer's disease in the United States and the public health impact of delaying disease onset. American Journal of Public Health 1998;88(9):1337-42.
Price BR, Wilcock DM, Weekman EM. Hyperhomocysteinemia as a risk factor for vascular contributions to cognitive impairment and dementia. Frontiers in Aging Neuroscience 2018;10:350.
Molero AE, Pino-Ramírez G, Maestre GE. High prevalence of dementia in a Caribbean population. Neuroepidemiology 2007;29(1-2):107-12.
Tantanokit T, Bosittipichet T, Leesri T. The study of prevalence and associated factors of dementia in the elderly. Siriraj Medical Journal 2021;73(4):224-35.
Wangtongkum S, Sucharitkul P, Silprasert N, Inthrachak R. Prevalence of dementia among population age over 45 years in Chiang Mai, Thailand. Journal of the Medical Association of Thailand 2008;91(11):1685.
Imtiaz B, Tolppanen AM, Kivipelto M, Soininen H. Future directions in Alzheimer's disease from risk factors to prevention. Biochemical Pharmacology 2014;88(4):661-70.
Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, D'Agostino RB, et al. Plasma homocysteine as a risk factor for dementia and Alzheimer's disease. New England Journal of Medicine 2002;346(7):476-83.
Smith AD, Refsum H, Bottiglieri T, Fenech M, Hooshmand B, McCaddon A, et al. Homocysteine and dementia: an international consensus statement. Journal of Alzheimer's Disease 2018;62(2):561-70.
Azzini E, Ruggeri S, Polito A. Homocysteine: its possible emerging role in at-risk population groups. International Journal of Molecular Sciences 2020;21(4):1421.
Wierzbicki AS. Homocysteine and cardiovascular disease: a review of the evidence. Diabetes and Vascular Disease Research 2007;4(2):143-9.
Williams KT, Schalinske KL. Homocysteine metabolism and its relation to health and disease. Biofactors 2010;36(1):19-24.
Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, et al. Homocysteine and folate as risk factors for dementia and Alzheimer disease. The American Journal of Clinical Nutrition 2005;82(3):636-43.
Chen S, Honda T, Ohara T, Hata J, Hirakawa Y, Yoshida D, et al. Serum homocysteine and risk of dementia in Japan. Journal of Neurology, Neurosurgery & Psychiatry 2020;91(5):540-6.
Chen PJ, Lu YC, Wang PM, Huang CF, Loke SS. Factors associated with hyperhomocysteinemia in relatively healthy Taiwanese adults: A retrospective medical record study. Medicine 2021;100(3).
Ardawi MS, Rouzi AA, Qari MH, Dahlawi FM, Al-Raddadi RM. Influence of age, sex, folate and vitamin B12 status on plasma homocysteine in Saudis. Saudi Medical Journal 2002;23(8):959-68.
Meng H, Li Y, Zhang W, Zhao Y, Niu X, Guo J. The relationship between cognitive impairment and homocysteine in a B12 and folate deficient population in China: a cross-sectional study. Medicine 2019;98(47).
Joosten E, van den Berg A, Riezler R, Naurath HJ, Lindenbaum J, Stabler SP, et al. Metabolic evidence that deficiencies of vitamin B− 12 (cobalamin), folate, and vitamin B− 6 occur commonly in elderly people. The American Journal of Clinical Nutrition 1993;58(4):468-76.
Leowattana W, Mahanonda N, Bhuripanyo K, Pokum S. Prevalence of hyperhomocysteinemia in normal healthy Thai subjects. Journal of Medical Association of Thailand 2001;84:S722-9.
Viroonudomphol D, Kajanachumpol S, Prawettongsopon C. Homocysteine and cognitive impairment in Thai elderly. World Journal of Engineering and Technology 2016;4(4):562-71.
International Labour Office. International Standard Classification of Occupations 2008 (ISCO-08): Structure, group definitions and correspondence tables. International Labour Office; 2012.
กระทรวงสาธารณสุข กรมการแพทย์ สถาบันเวชศาสตร์ผู้สูงอายุ.แบบทดสอบสภาพสมองเบื้องต้น ฉบับภาษาไทย MMSE-Thai 2002.กรุงเทพฯ: สถาบันเวชศาสตร์ผู้สูงอายุ กรมการแพทย์ กระทรวงสาธารณสุข; 2545.
Hemrungrojn S. Montreal cognitive assessment (MoCA) thai version 2007 [Internet]. 2011[cited 2023 Feb 8] Available from: http://www. mocatest.org/pdf_files/test/MoCATest-Thai.pdf.
Moretti R, Caruso P, Dal Ben M, Conti C, Gazzin S, Tiribelli C. Vitamin D, homocysteine, and folate in subcortical vascular dementia and Alzheimer dementia. Frontiers in Aging Neuroscience 2017;9:169.
Quadri P, Fragiacomo C, Pezzati R, Zanda E, Forloni G, Tettamanti M, et al. Homocysteine, folate, and vitamin B-12 in mild cognitive impairment, Alzheimer disease, and vascular dementia. The American Journal of Clinical Nutrition. 2004;80(1):114-22.
Yinglertratanakun P. Study of folate content in Thai food [Internet]. 2005 [cited 2023 Feb 8]. Available from: https://nutrition2.anamai.moph.go.th/th/research2/download?id=78315&mid=35886&mkey=m_document&lang=th&did=25211
Kwok T, Wu Y, Lee J, Lee R, Yung CY, Choi G, et al. A randomized placebo-controlled trial of using B vitamins to prevent cognitive decline in older mild cognitive impairment patients. Clin Nutr 2020; 39:2399–405.
Oulhaj A, Jernerén F, Refsum H, Smith AD, De Jager CA. Omega-3 fatty acid status enhances the prevention of cognitive decline by B vitamins in mild cognitive impairment. J Alzheimer Dis 2016; 50: 547–7.
Mielech A, Puścion-Jakubik A, Markiewicz-Żukowska R, Socha K. Vitamins in Alzheimer’s disease—Review of the latest reports. Nutrients 2020;12(11):3458.