Association of vitamin B12, folate and homocysteine with functional and pathological characteristics of the elderly in a mountainous village in Sicily.

Background: Homocysteine is associated with age, folate and vitamin B₁₂. Our study investigated the functional and clinical characteristics of the elderly (aged 60–85 years) of San Teodoro, a village in Central Sicily, and evaluated associations with vitamin B₁₂, folate and homocysteine. Methods: Subjects (n=280) were examined after door-to-door recruitment using interview, physician examination and laboratory tests. Results: A total of 19.3% of the population had a low blood level of folate (<7 nmol/L) and 3.2% had low vitamin B₁₂ concentration (<100 pmol/L). The level of dependency, determined by the Barthel index, influenced homocysteine blood levels (p<0.0001), independent of age (p<0.0001), folate (p=0.0028) and vitamin B₁₂ (p=0.0165). Homocysteine was significantly associated with stroke (p=0.0027) and peripheral arterial vascular disease (p=0.0001), but not with myocardial infarction, angina pectoris, venous thrombosis or cancer. Vitamin B₁₂ was lower in myocardial infarction and higher in diabetes and venous thrombosis compared to the other diseases. Conclusions: The prevalence of deficits in folate and vitamin B₁₂ was paradoxically high in the mountainous northeastern area of Sicily. Our study also underlines the association of homocysteine with dependency of the elderly and with stroke and peripheral arteriopathy. Clin Chem Lab Med 2007;45:136–42. [ABSTRACT FROM AUTHOR]