Common carotid artery intima-media thickness, carotid plaques, and walking speed.
OBJECTIVE
Gait dysfunction is an important cause of disability among the elderly and may be, in part, of vascular origin. We studied the association between carotid ultrasound parameters and measures of gait and balance in subjects 65 to 85 years of age who participated in the baseline phase of the Three-City Study in the Dijon center.


METHODS
The study population comprised 2572 noninstitutionalized individuals. Carotid plaques and common carotid artery intima-media thickness (CCA-IMT) were measured using ultrasonography. Gait and balance measures included walking speed and a modified version of the Tinetti scale.


RESULTS
Mean maximum walking speed (MWS) decreased with increasing CCA-IMT and number of plaques (P<10(-4)). Compared with subjects in the lowest CCA-IMT quintile, the odds ratio (95% CI) for being in the lowest MWS quartile was 1.1 (0.8 to 1.6) in the second, 1.3 (0.9 to 1.8) in the third, 1.7 (1.2 to 2.4) in the fourth, and 2.2 (1.6 to 3.1) in the higher CCA-IMT quintile (P<10(-4)). Mean (SD) CCA-IMT was 0.716 (0.118) mm in subjects with a modified Tinetti score <16 (25th percentile) and 0.685 (0.109) mm in subjects with a score of > or =16 (P=0.006). The proportion of subjects in the lowest MWS quartile (P=0.006) or with a modified Tinetti score <16 (P=0.05) increased with the number of plaques. These relations were attenuated after adjustment for vascular risk factors.


CONCLUSIONS
Carotid plaques and higher CCA-IMT values are associated with worse performances on gait and balance tests. Our results suggest that vascular factors may play an important and under-recognized role in motor function.
Elbaz
Alexis
A
INSERM, Unit 708, Paris, France. elbaz@chups.jussieu.fr
Ripert
Mahaut
M
Tavernier
Béatrice
B
Février
Benoît
B
Zureik
Mahmoud
M
Gariépy
Jérôme
J
Alpérovitch
Annick
A
Tzourio
Christophe
C
D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000473:pathology; D016893:Carotid Stenosis / Q000473:pathology*; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D009043:Motor Activity; D016017:Odds Ratio; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography; D016138:Walking