Factors associated with Dementia with special reference to Serum Homocysteine Level: A Case-Control Study
Abstract
Prevalence of degenerative dementias and dementias associated with cerebrovascular disease is increasing with the time. Dementia is one of the most significant public health problems. Demographic data, medical history, general biochemical data and serum total homocysteine (tHcy) levels was used in this study to examine the differences between dementia and normal control groups. A cross-sectional study was conducted on 236 individuals who were above the age of 65 years. These participants went through the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), demographic characteristics, biochemical data and tHcy level. Each of the above mentioned factors was assessed. There were significant differences in the history of hypertension, diabetes mellitus, marital status, alcohol consumption (AC), BMI value, and triglyceride (TG) and serum tHcy levels. The logistic regression analysis showed significant differences in marital status, AC and tHcy. So it can be concluded that elevated serum tHcy, no AC and no partner are associated with the risk of dementia in elders of Southern Taiwan. It needs further researches to identify and reduce the risk of dementia.
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Introduction
Dementia is characterized by a progressive deterioration of cognitive skills that leads to a decline in the ability to perform daily activities; Current data from developing countries suggest that age-adjusted dementia prevalence estimates in 65 year olds are high (≥5%) in certain Asian and Latin American countries. 1 The aging population in Taiwan has grown rapidly in the past decades, with an increase in the percentage of the population over age 65 from 6.8% to 12.51% in 1992 and 2015, respectively. 2 Sun’s study showed that the prevalence of mild cognitive impairment (MCI) prevalence was 18.76% (95% CI 17.91–19.61), this nationwide epidemiological study showed that MCI affects a considerable percentage of the population of Taiwan aged 65 and above and is more prevalent than dementia in Taiwan. 3 Chang’s research revealed that feeding difficulty has a higher prevalence in elderly patients with dementia in Taiwan. 4 Dementia is characterized by significant impairments in multiple cognitive domains, functioning, and behavior; dementia places a tremendous burden on the individuals and society. Chen’s research identified that dementia is a hidden health issue due to its underestimation in the elderly population within Taiwan and many other counties. 5
Homocysteine level is associated with endothelial dysfunction and vascular disease, as well as neuropsychiatric disorders. 6
Conclusion
Among the items that were examined, three factors: partner, AC and tHcy had significant influence on dementia. All these factors could be improved with changes in everyday life, such as having a better lifestyle (Living with partner or other family members), taking vitamins B-complex daily, improving current living conditions, having more social interaction with others and enjoying an active retirement by participating in community activities. 24 Alcohol consumption should be kept to a moderate amount. One should not drink excessively, and instead, utilize the flavonoids in alcohol for natural protection. In addition, a regular diet and exercise, avoiding high-salt foods, and good control of blood pressure are all ways to delay dementia. We could also use the tHcy as an indicator in the screening assessment and prevention of senile cognitive functioning. Some studies in recent years have shown that the tHcy is related to cognitive functioning. Folic acid, vitamin B12 and vitamin B6 can all reduce the serum tHcy level. 25