Premium
Optimal use of markers for cobalamin and folate status in a psychogeriatric population
Author(s) -
Nilsson Karin,
Gustafson Lars,
Hultberg Björn
Publication year - 2002
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.726
Subject(s) - cobalamin , methylmalonic acid , medicine , homocysteine , population , pathological , blood plasma , gastroenterology , vitamin b12 , endocrinology , environmental health
Abstract Background 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. It is therefore of importance to evaluate the optimal use of different markers of cobalamin/folate status in a psychogeriatric population. Methods We measured serum cobalamin, blood folate, plasma homocysteine (tHcy) and serum methylmalonic acid (MMA) in 475 well‐defined psychogeriatric patients. Results The findings in the present study showed that many (41%) of the patients with normal levels of serum MMA (<0.41 μmol/l) had pathological values of at least one of the other markers for cobalamin/folate status, whereas only 17% of patients with normal plasma tHcy (<19.9 μmol/l) had pathological levels of other markers. If patients with decreased levels of serum cobalamin and/or blood folate were also excluded from these patients, only nine patients with slightly elevated levels of serum MMA remained. In the present study different upper reference limits were also tested for both serum MMA and plasma tHcy. However, the use of these limits did not cause any diagnostic improvement in the evaluation of cobalamin–folate status. Plasma tHcy was increased in almost all diagnosis groups of the psychogeriatric patients, whereas serum MMA was increased in only some groups. The distribution of the two common polymorphisms of the methylenetetrahydrofolate reductase gene (C677T and A1298C) was similar in patients with elevated and normal plasma tHcy. Conclusions The findings in the present study suggest the use of plasma tHcy, serum cobalamin and blood folate to evaluate cobalamin–folate status in psychogeriatric patients and to omit the use of serum MMA. Copyright © 2002 John Wiley & Sons, Ltd.