Homocysteine and Dementia in Parkinson Disease

Abstract

Parkinson disease (PD) and dementia are neurodegenerative disorders that can be frequently seen in the elderly. Homocysteine (Hcy) is an intermediary metabolite from methylation, which is highly relevant to body physiologic activities including DNA metabolism. Elevated plasma level of homocysteine (eHcy) is seen in normal aging individuals and patients with neurologic disorders such as PD or dementia. Although clinical observations confirm the finding that eHcy is prevalent in PD patients, the former is not a recognized etiology causing PD but rather, an adverse outcome related to the therapy of dopaminergic supplementation. Notably, eHcy may exacerbate various medical and neurologic conditions such as cardiovascular diseases, stroke, mild cognitive impairment, all of which are potential risks for dementia. This chapter discusses the concerns of eHcy relative to dementia in PD.