Abstract

To determine if there is a cross-sectional association between homocysteine (tHcy) level and measures of gait and balance in elderly subjects. 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. 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). Elevated homocysteine concentrations are associated with worse motor performances in the elderly. These findings support the hypothesis of a vascular contribution to motor function.

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