Clinical Profile Of Dementia And Its Association With Homocysteine

Clinical Profile Of Dementia And Its Associatioan With Homocystrine

Authors

  • Narender Pal Jain
  • Shweta Gupta
  • Sanjeev Kumar Singla
  • Rajinder Kumar Bansal
  • Manbir Singh

Keywords:

Clinical dementia rating score, cognitive impairment, hyperhomocysteinemia, Mini-Mental State Examination score

Abstract

Background & Objectives : Dementia is a serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal ageing. This cross sectional study was undertaken to study clinical profile of dementia and its association with plasma homocysteine levels. Methods : 30 patients (indoor or outdoor) > 55 years with dementia were screened on Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR) Scale. A clinical dementia rating questionnaire was asked and plasma homocysteine levels measured by ELISA using Bio-rad reagents. Data was collected and statistically analyzed. Results : There was a statistically significant correlation between loss of memory (p = 0.047), orientation (p = 0.038), judgement/problem solving (p = 0.048), outer (p = 0.042), household (p = 0.048) and personal care activity (p = 0.0099) with hyperhomocysteinemia. A statistically significant correlation was found between CDR (p = 0.0081) and MMSE (p = 0.0095) score with hyperhomocysteinemia. Interpretation & Conclusion : A significant correlation was seen between memory loss, worsening of cognitive dementia, limitation of household activity, worsening of personal care, impairment of judgment and problem solving with hyperhomocysteinemia. As hyperhomocysteinemia can be effectively treated with a low cost therapy of B vitamin supplements, it is important to recognize these problems and treat them early.

References

1. Fadil H, Borazanci A, Haddou EAB, Yahyaoui M, Korniychuk E, Jaffe S L et al. Early Onset Dementia". International Review of Neurobiology. International Review of Neurobiology. 2009; 84: 245-62.
2. Hendrie HC, Hall KS, Ogunniyi A and Gao S. Alzheimer’s disease, genes, and environment: the value of international studies. Can J Psychiatry. 2004; 49(2):92-9.
3. 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. N Engl J Med. 2002; 346:476–83.
4. Christina BG and Teodoro B. Homocysteine, Related Vitamins and Neuropsychiatric Disorders. Springer Verlag. 2003; 2-287-04393-4.
5. Smith AD. Hyperhomocysteinemia, B vitamins, and cognitive deficit in the elderly. Editorial. Am J Clin Nutr. 2002; 75:785-6.
6. Kruman II, Kumaravel TS, Lohani A, Pedersen WA, Cutler RG, Kruman Y et al. Folic acid deficiency and homocysteine impair DNA repair in hippocampal neurons and sensitize them to amyloid toxicity in experimental models of Alzheimer’s disease. J Neurosci. 2002; 22 :1752 – 1762.
7. Folstein MF, Folstein SE and McHugh PR. "Mini-mental state: a practical method for
grading the cognitive state of patients for the clinician", J Psychiat Res. 1975; 12 (3): 189-98.
8. O'Bryant SE, Waring SC, Cullum CM, Hall J, Lacritz L, Massman PJ et al. Staging dementia using Clinical Dementia Rating Scale Sum of Boxes scores: a Texas Alzheimer's research consortium study. Arch Neurol. 2008; 65(8):1091-5.
9. Poddar K, Kant S, Singh A and Singh TB. An epidemiological study of dementia among the habitants of eastern Uttar Pradesh, India. Ann Indian Acad Neurol. 2011; 14(3): 164–68.
10. Kim MD, Park JH, Lee CI, Kang NR, Ryu JS, Jeon BH et al. Prevalence of dementia and its correlates among participants in the national early dementia detection program during 2006-2009. Psychiatry Invest. 2012;134-42.
11. Sachdev P, Parslow R, Salonikas C, Lux O, Wen W, Kumar R et al. Homocysteine and the brain in mid adult life. Arch Neurol. 2004;61:1369–76.
12. Morris MS, Jacques PF, Rosenberg IH and Seljuk J. Hyperhomo-cysteinemia associated with poor recall in the third National Health and Nutrition Examination Survey. Am J Clin Nutr. 2001;73:927–33.
13. Tu MC, Huang CW, Chen NC, Chang WN, Lui CC, Chen CF et al Hyperhomocysteinemia in Alzheimer Dementia Patients and Cognitive Decline after 6 Months Follow-up Period. Acta Neurol Taiwan. 2010;19:168-77.
14. 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. Am J Clin Nutr. 2004;80:114-22.
15. Tucker KL, Qiao N, Scott T, Rosenberg I, and Spiro A. High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study. Am J Clin Nutr. 2005;82: 627–35.

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Published

2013-08-31

How to Cite

Jain, N. P., Gupta, S., Singla, S. K., Bansal, R. K., & Singh, M. (2013). Clinical Profile Of Dementia And Its Association With Homocysteine: Clinical Profile Of Dementia And Its Associatioan With Homocystrine. National Journal of Integrated Research in Medicine, 4(4), 80–84. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/2211

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