{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:26:25Z","timestamp":1774272385643,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,4,5]],"date-time":"2016-04-05T00:00:00Z","timestamp":1459814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Basic Oriented Research","award":["RFO2011"],"award-info":[{"award-number":["RFO2011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Plasma total homocysteine (<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy) is a risk factor for ischemic stroke (<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>) but its relationship with<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>outcome is uncertain. Moreover, previous studies underrepresented older<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>patients, although risk of both hyperhomocysteinemia and<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>increases with age. We investigated whether, in elderly patients with acute<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy measured on admission to the Stroke Unit (<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>) is an independent predictor of<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>discharge outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Data are for 644 consecutive patients aged 80.3\u00a0\u00b1\u00a08.7\u00a0years, admitted to an Italian<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>with diagnosis of acute<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>. Plasma<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy was measured on<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>admission. Investigated outcomes included mortality during<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>stay and poor functional status (modified Rankin Scale score \u22653) at<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>discharge for survivors. The association of plasma<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy with the study outcomes was assessed using Odds Ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) and their corresponding 95% confidence intervals (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) from logistic regression models adjusted for demographics, pre\u2010stroke features,<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>severity, and laboratory data on<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>admission (serum C\u2010reactive protein, serum albumin, and renal function).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median plasma<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy was 16.7\u00a0<jats:italic>\u03bc<\/jats:italic>mol\/L (interquartile range, 13.0\u201323.3\u00a0<jats:italic>\u03bc<\/jats:italic>mol\/L). Outcome incidence was\u00a05.3% for mortality and 49.7% for poor functional status. Plasma<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy was unrelated to mortality in both univariate and multivariable\u2010adjusted analyses. Conversely, plasma<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy was associated with poor functional status of survivors in univariate analyses (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.014). Multivariable\u2010adjusted analyses showed that, compared to normal homocysteinemia (<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy &lt;16\u00a0<jats:italic>\u03bc<\/jats:italic>mol\/L), risk of being discharged with poor functional status significantly increased for moderate (<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy \u226530\u00a0mol\/L) but not mild (16.0\u201329.9\u00a0<jats:italic>\u03bc<\/jats:italic>mol\/L) hyperhomocysteinemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In elderly patients with acute<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>, high admission plasma<jats:styled-content style=\"fixed-case\">tH<\/jats:styled-content>cy is unrelated to mortality during<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>stay but is an independent predictor of poor functional status at<jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>discharge in survivors. The association, however, is limited to patients with moderate hyperhomocysteinemia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.460","type":"journal-article","created":{"date-parts":[[2016,4,10]],"date-time":"2016-04-10T13:08:08Z","timestamp":1460293688000},"source":"Crossref","is-referenced-by-count":16,"title":["Homocysteinemia and early outcome of acute ischemic stroke in elderly patients"],"prefix":"10.1002","volume":"6","author":[{"given":"Paola","family":"Forti","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabiola","family":"Maioli","sequence":"additional","affiliation":[{"name":"Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgia","family":"Arnone","sequence":"additional","affiliation":[{"name":"Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maura","family":"Coveri","sequence":"additional","affiliation":[{"name":"Geriatric Stroke Unit Medical Department Maggiore Hospital Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Luca","family":"Pirazzoli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Zoli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Procaccianti","sequence":"additional","affiliation":[{"name":"Neurology Stroke Unit Institute of Neurological Sciences (IRCCS) Maggiore Hospital Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,4,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.35"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-S067"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114510001236"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.20.7.864"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2010.36"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a3083"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/xJAHA.111.000034"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31827b1a41"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004070549"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000133317.49796.0E"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2006.01518.x"},{"key":"e_1_2_7_14_1","first-page":"541","article-title":"Experience from a multicentre stroke register: a preliminary report","volume":"54","author":"Hatano S.","year":"1976","journal-title":"Bull. 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