Homocysteine levels and decline in physical function: MacArthur Studies of Successful Aging.
OBJECTIVE
To test whether elevated homocysteine levels are associated with an increased risk of decline in physical function in older persons.


METHODS
We performed a prospective cohort study of 499 highly functioning men and women aged 70 to 79 years who were enrolled in the MacArthur Studies of Successful Aging. We measured total homocysteine levels and performance-based physical function at baseline; physical function measures were repeated an average of 28 months later. A summary measure of physical performance from tests of balance, gait, lower body strength and coordination, and manual dexterity was developed, and a change score was calculated as the difference in scores from 1988 to 1991.


RESULTS
The mean (+/-SD) homocysteine level was 11.6 +/- 4.3 micromol/L. With each SD increase in homocysteine, there was an increased risk of being in the worst quartile of decline in physical function (odds ratio = 1.5; 95% confidence interval: 1.2 to 1.9) in analyses that adjusted for age, sex, baseline physical performance, smoking status, vitamin B(12) levels, and incident stroke. Similar results were seen when change in physical performance was treated as a continuous variable.


CONCLUSIONS
Older persons with elevated plasma homocysteine levels are at an increased risk of decline in physical function.
Kado
Deborah M
DM
Division of Geriatrics, Department of Medicine, University of California-Los Angeles, 10945 Le Conte Avenue, Los Angeles, CA 90095, USA. dkado@mednet.ucla.edu
Bucur
Alexander
A
Selhub
Jacob
J
Rowe
John W
JW
Seeman
Teresa
T
D000368:Aged; D000375:Aging / Q000097:blood / Q000502:physiology*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005684:Gait; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D016014:Linear Models; D008297:Male; D009048:Motor Skills; D009119:Muscle Contraction; D016017:Odds Ratio; D004856:Postural Balance; D011446:Prospective Studies; D011597:Psychomotor Performance; D012306:Risk
D015415:Biomarkers; D006710:Homocysteine