Homocysteine and mobility in older adults

OBJECTIVES: To determine the influence of homocysteine on mobility decline in older adults. DESIGN: Prospective cohort. SETTING: Einstein Aging Study, community-based aging study. PARTICIPANTS: Five hundred seventy-four older adults without dementia (mean age 80.2 ± 5.4, 61% women). MEASUREMENTS: Mobility decline defined using gait velocity measurements at baseline and annual follow-up visits. Linear mixed effects models were used to adjust for age, sex, education, and other potential confounders. RESULTS: Higher homocysteine levels were associated with slower gait velocity at baseline. Adjusted for age, sex, and education, a one-unit increase in baseline log homocysteine levels was associated with a 2.95-cm/s faster mobility decline per year (P=.01) over a median follow-up of 1.4 years. The 140 subjects in the highest quartile of homocysteine had a faster rate of mobility decline (1.75 cm/s per year faster, P=.01) than the 434 subjects in the lowest three quartiles of homocysteine (≤15 μmol/L). The association between homocysteine and mobility decline remained robust even after adjusting for multiple confounders and accounting for the presence of clinical gait abnormalities. CONCLUSION: Higher homocysteine levels are associated with greater risk of mobility decline in community-residing older adults.