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Optimal use of markers for cobalamin and folate status in a psychogeriatric population.
Int J Geriatr Psychiatry 2002; 17(10):919-25IJ

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 micromol/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 micromol/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.

Authors+Show Affiliations

Departments of Psychogeriatrics, University Hospital, Lund, Sweden.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12325051

Citation

Nilsson, Karin, et al. "Optimal Use of Markers for Cobalamin and Folate Status in a Psychogeriatric Population." International Journal of Geriatric Psychiatry, vol. 17, no. 10, 2002, pp. 919-25.
Nilsson K, Gustafson L, Hultberg B. Optimal use of markers for cobalamin and folate status in a psychogeriatric population. Int J Geriatr Psychiatry. 2002;17(10):919-25.
Nilsson, K., Gustafson, L., & Hultberg, B. (2002). Optimal use of markers for cobalamin and folate status in a psychogeriatric population. International Journal of Geriatric Psychiatry, 17(10), pp. 919-25.
Nilsson K, Gustafson L, Hultberg B. Optimal Use of Markers for Cobalamin and Folate Status in a Psychogeriatric Population. Int J Geriatr Psychiatry. 2002;17(10):919-25. PubMed PMID: 12325051.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Optimal use of markers for cobalamin and folate status in a psychogeriatric population. AU - Nilsson,Karin, AU - Gustafson,Lars, AU - Hultberg,Björn, PY - 2002/9/27/pubmed PY - 2002/11/28/medline PY - 2002/9/27/entrez SP - 919 EP - 25 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 17 IS - 10 N2 - 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 micromol/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 micromol/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. SN - 0885-6230 UR - https://www.unboundmedicine.com/medline/citation/12325051/Optimal_use_of_markers_for_cobalamin_and_folate_status_in_a_psychogeriatric_population_ L2 - https://doi.org/10.1002/gps.726 DB - PRIME DP - Unbound Medicine ER -