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BACKGROUND/OBJECTIVES: Elevated plasma homocysteine has been linked to reduced mobility and muscle functioning in the elderly. The relation of methylenetetrahydrofolate reductase (MTHFR) 677C → T polymorphism with these associations has not yet been studied. This study aimed to investigate (1) the association of plasma homocysteine and the MTHFR 677C → T polymorphism with muscle mass, handgrip strength, physical performance and postural sway; (2) the interaction between plasma homocysteine and the MTHFR 677C → T polymorphism. SUBJECTS/METHODS: Baseline data from the B-PROOF study (n = 2919, mean age = 74.1 ± 6.5) were used. Muscle mass was measured using dual X-ray absorptiometry, handgrip strength with a handheld dynamometer, and physical performance with walking-, chair stand- and balance tests. Postural sway was assessed on a force platform. The data were analyzed using regression analyses with plasma homocysteine levels in quartiles. RESULTS: There was a significant inverse association between plasma homocysteine and handgrip strength (quartile 4: regression coefficient B = - 1.14, 95% confidence interval (CI) = -1.96; -0.32) and physical performance score (quartile 3: B = - 0.53, 95% CI = -0.95; -0.10 and quartile 4: -0.94; 95% CI = -1.40; -0.48) in women only, independent of serum vitamin B12 and folic acid. No association was observed between the MTHFR 677C [right arrow] T polymorphism and the outcomes. High plasma homocysteine in the 677CC and 677CT genotypes, but not in the 677TT genotype, was associated with lower physical performance. CONCLUSIONS: Elevated plasma homocysteine concentrations are associated with reduced physical performance and muscle strength in older women. There is an urgent need for randomized controlled trials to examine whether lowering homocysteine levels might delay physical decline. European Journal of Clinical Nutrition (2013) 67, 743-748; doi: 10.1038/ejcn.2013.97; published online 22 May 2013 Keywords: homocysteine; MTHFR 677C → T polymorphism; mobility limitation; muscle strength; aged, INTRODUCTION Muscle tissue is progressively lost with aging, contributing to a decline in muscle strength. Muscle weakness and loss of muscle strength are risk factors of reduced physical functioning, increased [...]

Background/Objectives: This study aimed to investigate whether higher homocysteine and lower vitamin B12 concentrations increase the risk of future nursing home (NH) admission and all-cause mortality in independently living older persons. Subjects/Methods: In total, 1117 independently living participants (mean age = 75.1, s.d. = 6.4) were included in this prospective sub-study of the Longitudinal Aging Study Amsterdam. EDTA plasma samples, collected in 1995-1996, were analysed for total homocysteine (umol/l). Time to NH admission was assessed using a follow-up until 2002-2003. In addition, we studied mortality until 1 June 2007. Cox proportional hazards models were used to examine the association between homocysteine in quartiles and risk of NH admission and mortality. Results: During follow-up, 126 persons (11.3%) were admitted to NHs, and 513 persons (45.9%) deceased. In men, no significant associations were observed. In women, after adjustment for confounding, the highest quartile of homocysteine was associated with a significantly higher risk of NH admission compared with the first quartile (hazard ratio (HR) = 2.97, 95% confidence interval (CI) = 1.36-6.49). Both women in the third and the fourth quartile of homocysteine had a significantly higher mortality risk (HR = 1.70, 95% CI = 1.08-2.65 and HR = 1.91, 95% CI = 1.22-3.00, respectively) compared with the first quartile. Vitamin B12 was not related to an increased risk of NH admission and mortality. Conclusions: Elevated plasma homocysteine is associated with an increased risk of NH admission and mortality in older women, but not in older men. European Journal of Clinical Nutrition (2012) 66, 188-195; doi: 10.1038/ejcn.2011.186; published online 9 November 2011 Keywords: homocysteine; vitamin B12; nursing homes; mortality; aged, Introduction In the older population, elevated plasma homocysteine concentrations are present in 30-50% of the persons (de Bree et al., 2005). Plasma homocysteine concentrations are influenced by a complex interaction [...]

Background/Objectives: Decreases in physical performance are associated with multiple negative health outcomes. The objective of this study was to examine whether high plasma homocysteine and low serum vitamin B12 are independent risk factors for lower physical performance, both cross-sectionally and longitudinally. Subjects/Methods: This study was performed in persons aged ≥ 65 years of the LASA (Longitudinal Aging Study Amsterdam), an ongoing cohort study. Blood was collected in 1995/1996 (n = 1352). Physical performance was assessed in 1995/1996 and in 1998/1999 using three tests: the walking test, the chair stands test and the tandem stand (n = 901-1155). Results: After adjustment for confounding, women in the highest quartile of homocysteine had a significantly lower physical performance than did those in the lowest quartile in the cross-sectional analyses (β = -0.93, s.e. = 0.34, P Conclusions: High plasma homocysteine is an independent risk factor for lower physical performance in older women. The association between vitamin B12 and physical performance is less clear. European Journal of Clinical Nutrition (2012) 66, 174-181; doi: 10.1038/ejcn.2011.151; published online 24 August 2011 Keywords: homocysteine; older people; physical performance; vitamin B12, Introduction Homocysteine levels increase and vitamin B12 levels decrease with aging (Jacques et al., 1999; Refsum et al., 2004; Allen, 2009). In the LASA (Longitudinal Aging Study Amsterdam), a representative [...]