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Optimal use of markers for cobalamin and folate status in a psychogeriatric population.

Nilsson, Karin; Gustafson, Lars LU and Hultberg, Björn LU (2002) In International Journal of Geriatric Psychiatry 17(10). p.919-925
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 &mgr;mol/l) had pathological values of at least one of the other markers for cobalamin/folate status, whereas only 17%... (More)
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 &mgr;mol/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 &mgr;mol/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. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
International Journal of Geriatric Psychiatry
volume
17
issue
10
pages
919 - 925
publisher
John Wiley and Sons Ltd
external identifiers
  • wos:000178760500004
  • pmid:12325051
  • scopus:0036799592
ISSN
1099-1166
DOI
10.1002/gps.726
language
English
LU publication?
yes
id
7a82b276-78b6-41a1-a344-ac7a96b21100 (old id 110170)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12325051&dopt=Abstract
date added to LUP
2007-07-05 13:48:46
date last changed
2017-01-01 04:30:13
@article{7a82b276-78b6-41a1-a344-ac7a96b21100,
  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 (&lt;0.41 &amp;mgr;mol/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 (&lt;19.9 &amp;mgr;mol/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 &amp; Sons, Ltd.},
  author       = {Nilsson, Karin and Gustafson, Lars and Hultberg, Björn},
  issn         = {1099-1166},
  language     = {eng},
  number       = {10},
  pages        = {919--925},
  publisher    = {John Wiley and Sons Ltd},
  series       = {International Journal of Geriatric Psychiatry},
  title        = {Optimal use of markers for cobalamin and folate status in a psychogeriatric population.},
  url          = {http://dx.doi.org/10.1002/gps.726},
  volume       = {17},
  year         = {2002},
}