Decreased serum trefoil factor 3 (TFF3)/cholinesterase (ChE) activity and increased homocysteine (Hcy) are associated with vascular function, inflammation, and oxidative stress, which may underlie the pathophysiological mechanisms of PD dementia (PDD) and vascular parkinsonism with dementia (VPD). The gene discussed is TFF3; the disease is velopharyngeal dysfunction.