Research Article

Homocysteine in neuropsychiatric disorders of the elderly

  1. Sharon Reutens1,2,*,
  2. Perminder Sachdev1,2

Article first published online: 9 SEP 2002

DOI: 10.1002/gps.723

Issue

International Journal of Geriatric Psychiatry

International Journal of Geriatric Psychiatry

Volume 17, Issue 9, pages 859–864, September 2002

Additional Information

How to Cite

Reutens, S. and Sachdev, P. (2002), Homocysteine in neuropsychiatric disorders of the elderly. International Journal of Geriatric Psychiatry, 17: 859–864. doi: 10.1002/gps.723

Author Information

  1. 1

    Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia

  2. 2

    University of New South Wales, Sydney, Australia

*NPI, Prince of Wales Hospital, Barker Street, Randwick, NSW 2031, Australia.

Publication History

  1. Issue published online: 9 SEP 2002
  2. Article first published online: 9 SEP 2002
  3. Manuscript Accepted: 16 JUL 2002
  4. Manuscript Received: 10 DEC 2001

Funded by

  • National Health and Medical Research Council of Australia

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Keywords:

  • homocysteine;
  • Alzheimer's disease;
  • depression;
  • vascular dementia;
  • stroke;
  • Parkinson's disease;
  • folate;
  • nutrition

Abstract

Objective

There is increasing interest in homocysteine as a risk factor for neuropsychiatric disorders such as stroke, dementia, depression and Parkinson's disease. This article reviews the current literature on the relationship between homocysteine and these disorders to ascertain if any clinical recommendations can be made.

Method

A MEDLINE and EMBASE search was made for English language publications between 1966 and 2002 using the search terms ‘Homocysteine’ and ‘Stroke’, ‘Dementia’, ‘Vascular Dementia’, ‘Alzheimer's dementia’, ‘Cognition disorders or cognitive decline or memory disorders’, ‘Depression or depressive disorders’ or ‘Parkinson's disease’. In addition, individual articles were hand searched for relevant references.

Results

Cross-sectional studies consistently suggest that elevated homocysteine increases the risk of stroke, and may also increase the risk of leukoariosis, vascular dementia (VaD), cognitive impairment and Alzheimer's disease (AD). Longitudinal studies of homocysteine as a risk factor are few and inconsistently supportive of these associations. No intervention trials to determine the effect of lowering homocysteine levels have yet been published. The pathological mechanisms for homocysteine-mediated disease await complete elucidation. Mild hyperhomocysteinemia is common in the elderly population, and folate supplementation can decrease homocysteine levels.

Conclusion

The epidemiological evidence for homocysteine as a risk factor for neuropsychiatric disease is an emerging area of great interest. Screening the population for hyperhomocysteinemia cannot be recommended at this stage, but individuals at increased risk of cerebrovascular disease or cognitive impairment should be investigated and treated for elevated homocysteine levels. Copyright © 2002 John Wiley & Sons, Ltd.

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