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From INSERM (A.S., A.E., A.A., C.T.), Unit 708, Université Pierre et Marie Curie-Paris, 3C Study Center (B.T.), Dijon, and Laboratoire Nutrition (V.D.), Vieillissement et Maladies Cardiovasculaires, Université Joseph Fourier, Grenoble, France.
Address correspondence and reprint requests to Dr. A. Elbaz, INSERM Unit 708, 75651 Paris Cedex 13, France; e-mail: elbaz{at}chups.jussieu.fr
Objective: To determine if there is a cross-sectional association between homocysteine (tHcy) level and measures of gait and balance in elderly subjects.
Methods: We studied 3,609 noninstitutionalized subjects aged 65 to 85 years from the Dijon (France) center of the Three-City Study. tHcy concentration was measured from fasting blood samples. Motor function was assessed by measuring walking speed and by using a modified version of the Tinetti scale.
Results: After adjustment for confounders, mean maximum walking speed (MWS) decreased with increasing tHcy levels (p = 0.001). The odds ratio (OR) (95% CI) for having a MWS below the 40th percentile was 1.9 (1.4 to 2.5) in subjects with tHcy levels in the upper quintile compared with those in the lowest quintile. Compared with subjects in the lowest tHcy quintile, the OR for having a modified Tinetti score below 16 ranged from 1.0 (0.8 to 1.4) in the second quintile to 1.9 (1.3 to 2.6) in the upper quintile (p < 0.0001).
Conclusions: Elevated homocysteine concentrations are associated with worse motor performances in the elderly. These findings support the hypothesis of a vascular contribution to motor function.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the September 26 issue to find the title link for this article.
The 3C Study is conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the Victor Segalen-Bordeaux II University and the Sanofi-Synthélabo Company. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Conseils Régionaux of Aquitaine, Languedoc-Roussillon and Bourgogne, Fondation de France, Ministry of Research-INSERM Program "Cohortes et collections de données biologiques," Mutuelle Générale de l'Education Nationale, Institut de la longévité, and Conseil Général de la Côte d'or.
Disclosure: The authors report no conflicts of interest.
Received December 21, 2005.
Accepted in final form May 23, 2006.
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E. D. Louis, N. Schupf, M. X. Tang, K. Marder, and J. A. Luchsinger Mild Parkinsonian Signs and Plasma Homocysteine Concentration in Community-Dwelling Elderly Individuals Arch Neurol, November 1, 2007; 64(11): 1646 - 1651. [Abstract] [Full Text] [PDF] |
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