Association of plasma homocysteine in elderly persons with atherosclerotic vascular disease and dementia, atherosclerotic vascular disease without dementia, dementia without atherosclerotic vascular disease, and no dementia or atherosclerotic vascular disease

Background. Increased plasma homocysteine has been associated with atherosclerotic vascular disease in elderly persons. The Framingham Study found that plasma homocysteine was a risk factor for dementia and Alzheimer's disease. Methods. We investigated in an academic nursing home the association of plasma homocysteine with atherosclerotic vascular disease plus dementia (group 1), atherosclerotic vascular disease without dementia (group 2), dementia without atherosclerotic vascular disease (group 3), and no dementia or atherosclerotic vascular disease (group 4). Results. The mean plasma homocysteine level was 15.3 +/- 3.0 mumol/L in 50 group 1 patients, 15.1 +/- 2.7 mumol/L in 50 group 2 patients, 14.4 +/- 2.7 mumol/L in 50 group 3 patients, and 10.6 +/- 3.2 mumol/L in 50 group 4 patients (p < .0001 for croup 1 vs group 4, for group 2 vs group 4, and for group 3 vs group 4). Conclusions. The mean plasma homocysteine level was significantly higher in elderly patients with atherosclerotic vascular disease plus dementia, atherosclerotic vascular disease without dementia, and dementia without atherosclerotic vascular disease than in patients with no dementia or atherosclerotic vascular disease.