Key result
APOE4 status linked to ~45% higher vascular disease prevalence and elevated homocysteine in elderly psychiatric patients.
Why the study?
Is APOE4 carrier status associated with increased plasma homocysteine and vascular disease prevalence in elderly patients with mental illness?
Cross-Sectional (n=328)
No
Is APOE4 carrier status associated with increased plasma homocysteine and vascular disease prevalence in elderly patients with mental illness?
APOE4 carriers among elderly patients with mental illness have higher plasma homocysteine levels and a greater prevalence of vascular disease, suggesting a need for intensive risk factor management.
Answers are grounded in this paper and cite their sources.
Should not change clinical management in elderly mental illness; leaves open whether APOE4 influences homocysteine and vascular risk.
BACKGROUND: Total plasma homocysteine (tHcy) concentration is increased in elderly patients with mental illness. Also, patients with vascular disease have significantly higher plasma tHcy concentration compared with patients without vascular disease. Apolipoprotein E (apoE) status is associated with cardiovascular disease and a major genetic risk factor is inheritance of the e4 allele. In the present study, we investigated the association between plasma tHcy and apoE status. METHODS: The relation between apoE status, plasma tHcy and vascular disease was investigated in a cohort of consecutively enrolled elderly patients with mental illness (n=328). RESULTS: Plasma tHcy concentrations were increased (p<0.01) in carriers of APOE4 (13.6 micromol/L; 9.2-21.7 micromol/L) compared to non-carriers (12.4 micromol/L; 8.3-19.9 micromol/L). The proportion of patients with vascular disease was significantly (p<0.001) increased among carriers (61%) compared to non-carriers (42%). An increased percentage (p<0.001) of APOE4 carriers was observed in patients with Alzheimer's disease (AD) with (71%) or without vascular disease (42%), and in patients with vascular dementia (VaD) (54%) compared to a reference group (34%). CONCLUSIONS: Since carriers of APOE4 showed an increased likelihood of vascular disease, these patients need more intensive control of other modifiable vascular risk factors. Furthermore, the association between plasma tHcy and the presence of APOE4 might be attributed to an increased proportion of vascular disease in APOE4 carriers.
No takes yet. Share an insight, caveat, or question.
Nilsson et al. (2009) conducted a cross-sectional in Mental illness (n=328). APOE4 carrier status vs. APOE4 non-carriers was evaluated on Plasma total homocysteine (tHcy) concentration (mmol/L) (p=<0.01). APOE4 carrier status in elderly patients with mental illness was associated with significantly higher plasma homocysteine concentrations (13.6 vs 12.4 mmol/L) and an increased prevalence of vascular disease (61% vs 42%).
Synapse has enriched 10 related papers. Consider them for comparative context: