Department of General Internal Medicine, New York University School of Medicine, New York, New York 10461, USA.
J Am Geriatr Soc. 2010 Mar;58(3):545-50. doi: 10.1111/j.1532-5415.2010.02718.x. Epub 2010 Feb 11.
To determine the influence of homocysteine on mobility decline in older adults.
Prospective cohort.
Einstein Aging Study, community-based aging study.
Five hundred seventy-four older adults without dementia (mean age 80.2 +/- 5.4, 61% women).
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.
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 (<or=15 micromol/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.
Higher homocysteine levels are associated with greater risk of mobility decline in community-residing older adults.
确定同型半胱氨酸对老年人活动能力下降的影响。
前瞻性队列研究。
爱因斯坦老龄化研究，基于社区的老龄化研究。
574 名无痴呆的老年人（平均年龄 80.2 +/- 5.4，61%为女性）。
采用基线和每年随访时的步态速度测量来定义活动能力下降。线性混合效应模型用于调整年龄、性别、教育程度和其他潜在混杂因素。
同型半胱氨酸水平较高与基线时的步态速度较慢相关。在校正年龄、性别和教育程度后，基线 log 同型半胱氨酸水平每增加 1 单位，每年的移动能力下降速度就会加快 2.95 厘米/秒（P=.01），中位随访时间为 1.4 年。同型半胱氨酸最高四分位数的 140 名受试者的移动能力下降速度较快（每年快 1.75 厘米/秒，P=.01），而同型半胱氨酸最低三分位数的 434 名受试者则较慢（<=15 微摩尔/升）。即使在调整了多种混杂因素并考虑了临床步态异常的存在后，同型半胱氨酸与移动能力下降之间的关联仍然很稳健。
同型半胱氨酸水平较高与社区居住的老年人活动能力下降的风险增加相关。
