Correlation between plasma homocysteine levels and behavioral and psychological symptoms in patients with mild to moderate vascular dementia

Abstract

Objective To explore the correlation between serum homocysteine(Hcy) levels and behavioral and psychological symptoms dementia(BPSD) in patients with mild to moderate vascular dementia(VaD). Methods Two hundred and ninety-three patients with mild to moderate vascular dementia (aged 40 or over) admitted to the department of neurology of the First Affiliated Hospital of Liaoning Medical College from January 2012 to January 2015. Patients were diagnosed with dementia by NINDS-AIREN criteria, MMSE scores ≤26, Hachinski ischemic scale(≥4) and clinical dementia rating(1≤CDR≤2). VaD patients were divided into high Hcy(HHcy) group (Hcy≥15 μmol/L, n=188) and control group(Hcy<15 μmol/L, n=105). The total scores and the scores of 12 functional domains of behavioral and psychological symptoms in NPI were analyzed by using comparative statistical methods. Results Prevalence of high homocysteine was 64.16% (n=188) among mild to moderate VaD (n=293). The incidence of BPSD in HHcy group(80.9%) was significantly higher than that in the control group(57.1%), the difference was statistically significant (χ2=18.932, P 0.05). Conclusion High homocysteine levels are correlated with behavioral and psychological symptoms in patients with mild to moderate VaD, including performance of sleep disorders, high, irritability / mood swings, abnormal behavior, disinhibition and agitation. Moreover, the severity of BPSD is positively associated with homocysteine levels. The higher the homocysteine level, the more severe the BPSD. The serum homocysteine levels are no correlated with infarcted brain focus. Key words: Vascular dementia; Behavioral and psychological symptom; Neuropsychiatric inventory; Homocysteine