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Biomedical subjects

Johan Lökk

Publications and source records attributed to Johan Lökk.

16 recordsLinked to original sources
PubMed2005

The relation between homocysteine levels and development of Alzheimer's disease in mild cognitive impairment patients.

The aim of this study was to investigate over a 3-year period the connection between homocysteine (Hcy) levels and development of Alzheimer's disease (AD) in patients with mild cognitive impairment (MCI). Hcy was analyzed in 68 men, mean age 65 years, and 68 women, mean age 64 years. Age, sex, cobalamin, folate, creatinine, and thyroid profiles as well as results of Mini-Mental State Examination at the first visit to the memory investigation unit of a geriatric department were recorded from patient journals collected between 1992 and 1999. The total numbers of persons who converted to AD within a period of 3 years from initial investigation with baseline Hcy sampling was 12 of 46 (26%) males, and 18 of 50 women (36%). The total percentage of men and women converting to AD was 31%. Thirty-three percent of men with Hcy levels >20 micromol/l converted to AD. The corresponding figure for men with Hcy levels 20-17 micromol/l was 50%, whereas none of the 18 men with Hcy levels <17 micromol/l converted to AD. These differences were statistically significant. There was also a statistically significant difference between the percentage of women with Hcy levels >16 micromol/l who converted to AD (45%) as compared to those with Hcy levels <16 micromol/l who converted (21%). These findings are inconsistent with the results of other studies showing a positive correlation with hyperhomocysteinemia and occurrence of AD. However, our findings tentatively suggest a possible protective effect of low/normal Hcy levels on dementia conversion in MCI patients.

Aged↗
PubMed2004

[Memantine can relieve certain symptoms in Parkinson disease. Improvement achieved in two out of three described cases with dyskinesia and cognitive failure].

Parkinson's disease is a chronic, progressive, neurodegenerative disease with a reduction of dopamine levels causing the typical symptoms tremor, hypokinesia, rigidity, and postural disturbance. After some years with Parkinson's disease patients tend to develop fluctuating symptoms and dyskinesia with involuntary movements--a state difficult to manage. Different pharmacological as well as non-pharmacological strategies are used and being tried. One of these is targeting the dysfunctioning glutamatergic neurotransmitter system through the NMDA-receptors. The NMDA-receptor antagonist amantadine has long been used as an anti-Parkinson drug but also as an anti-dyskinetic drug. Recently, another NMDA-receptor antagonist, memantine, was approved for moderate to severe Alzheimer's dementia in Sweden. We describe the use of memantine on three cognitively impaired, dyskinetic Parkinsonian patients where two seemed to benefit from this medication regarding their dyskinesia.

Aged↗
PubMed2003

[Treatment with levodopa can affect latent vitamin B 12 and folic acid deficiency. Patients with Parkinson disease runt the risk of elevated homocysteine levels].

There is a well-known interaction between vitamin B12, folate, and homocysteine. More unknown is the fact that this interaction might be affected by long-term treatment with levo-dopa in patients with Parkinson's disease. An increase in homocysteine levels and tissue deficiency of vitamin B12 and folate may occur. The responsible doctor should be liberal in checking vitamin B12 and folate status and supplement with appropriate vitamins when needed.

Animals↗
PubMed2003

News and views on folate and elderly persons.

Elderly persons are especially exposed to folate deficiency, where normal/subnormal folate levels do not exclude tissue deficiency. Accompanying diseases, medication, and lifestyle factors may contribute to/cause deficiency. Symptoms of deficiency can be hematological, neurological, or neuropsychiatric, but it is likely that there are also cardiovascular manifestations as well as associations with malignancies. The physician should make an individualized investigation to establish the probable cause. Among the available determinants of the folate/cobalamin state, plasma homocysteine (Hcy) is a swift and sensitive marker and has the strongest connection to cognitive function. The association is generally stronger between Hcy levels and symptoms than between vitamin-related levels and symptoms. The duration as well as the severity of symptoms are of importance in terms of the improvement of neurological and neuropsychiatric symptoms when substitution is performed. The issue of general folate fortification of flour is complex, and there are as many pros and cons as there are countries in which it is considered to be launched. It is important to bear in mind that in our modern society, deficiency of folate/cobalamin--overt or latent--mainly is a problem of the elderly and a challenge to the doctor.

Aged↗
PubMed2002

Sex differences in cobalamin vitamin B12 opinions of Swedish physicians.

The aim of the study was to elucidate possible sex differences in knowledge, competence and attitudes behind decision-making on cobalamin-associated problems (vitamin B(12)). The study was conducted by postal questionnaires to Swedish physicians in 1996-98. The participants were recruited by random sampling of general practitioners (1996, 1998), and a total sampling of geriatricians (1998). The overall response rate was 71%. The study group comprised 480 female physicians and 526 male physicians. The responses to 24 statements in the questionnaire were measured by means of visual analogue scales. Group differences were evaluated by medians and shapes of distributions. The female doctors appeared to value patient-related symptoms and signs more than male doctors. Conversely, male doctors relied on laboratory tests more than female doctors. As reflected by questionnaire answers, female doctors appeared to be more informed than male doctors on cobalamin-associated clinical problems. Group differences between the sexes were marginal from a numerical point of view. It is suggested that the statistical differences observed should be regarded as negligible until confirmed by further studies.

Clinical Competence↗
PubMed2002

Work site change and psychosocial well-being among health care personnel in geriatric wards--effects of an intervention program.

The study evaluated the effect of a change of work site and organization on work environment and psychosocial parameters: the change involved health care personnel at a geriatric hospital. Another aim of this study was to evaluate the effects of a structured psychoeducational intervention program. The study found few changes in the indices of interest on the experimental and control wards. There were, however, significant improvements in social climate, goal quality, and independence of work on the control ward. The investigators postulated that too much external support hampers a group's ability to actively cope with change and might actually lower a group's ability and self-esteem. In order to achieve successful organizational change, psychosocial intervention programs for personnel must be performed by a well-informed, well-chosen, and experienced counsellor who is well tailored to the local organization.

Adaptation, Psychological↗
PubMedDate not supplied

The significance of thyroid-stimulating hormone and homocysteine in the development of Alzheimer's disease in mild cognitive impairment: a 6-year follow-up study.

Mild cognitive impairment (MCI) represents a transition between normal aging and Alzheimer's disease (AD). The aim of this study was to investigate the predictive value of vitamin B12/folate, homocysteine, standard laboratory parameters, and concomitant diseases for development of AD in persons with an MCI diagnosis. Development of dementia was followed for 6 years in 93 consecutively recruited MCI persons. Information concerning the above factors was obtained from medical journals. Thirty-four percent of participants converted to AD within 6 years. A forward stepwise logistic regression was performed. The odds ratio (OR) for the Mini-Mental State Examination (MMSE) was 0.777; for age, 1.084; and for thyroid stimulating hormone (TSH), 0.287. The OR for homocysteine was 1.287 at 60 years of age and 1.087 at 65 years of age. Lower TSH levels together with the more established factors lower MMSE, higher homocysteine levels, and age were found to be predictive factors of AD. This may have clinical implications with regard to monitoring TSH levels and thyroxin substitution in MCI patients.

Age Factors↗