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Elan D. Louis, MD, MSc; Nicole Schupf, PhD, DrPH; Ming X. Tang, PhD; Karen Marder, MD, MPH; Jose A. Luchsinger, MD, MPH

Arch Neurol. 2007;64(11):1646-1651.

Objective  To determine whether plasma homocysteine (Hcy) concentration is associated with mild parkinsonian signs (MPS) in community-dwelling elderly individuals.

Design  Cross-sectional analyses of a population-based cohort study.

Setting  Washington Heights–Inwood, New York.

Patients  Persons without dementia 65 years and older.

Main Outcome Measure  Participants underwent an abbreviated motor portion of the Unified Parkinson's Disease Rating Scale. Each participant was assigned an MPS score (range, 0-40). The Hcy concentration was measured from plasma. All analyses were cross-sectional.

Results  There were 369 participants (mean ± SD age, 77.8 ± 6.0 years; mean ± SD MPS score, 1.51 ± 2.55; mean ± SD plasma Hcy concentration, 17.3 ± 6.5 µmol/L). Mean ± SD MPS scores in plasma Hcy concentration quintiles were as follows: lowest quintile, 1.15 ± 1.77; second quintile, 1.18 ± 1.88; third quintile, 1.64 ± 2.93; fourth quintile, 1.45 ± 2.17; and highest quintile, 2.12 ± 3.49 (84.3% higher than 1.15) (P = .02). In an unadjusted linear regression model, plasma Hcy concentration was associated with log MPS score (dependent variable) (P = .008). In a linear regression model that adjusted for confounding variables, plasma Hcy concentration was associated with log MPS score (P = .04).

Conclusions  These data indicate that MPS are associated with higher plasma Hcy concentrations. Prospective neuroimaging as well as clinical-pathological studies would further our understanding of several mechanisms that could underlie the observed association.

Author Affiliations: The Gertrude H. Sergievsky Center (Drs Louis, Schupf, Tang, and Marder), Departments of Neurology (Drs Louis and Marder), Psychiatry (Drs Marder and Schupf), and Medicine (Dr Luchsinger), and Taub Institute for Research of Alzheimer's Disease and the Aging Brain (Drs Louis, Schupf, Tang, Marder, and Luchsinger), College of Physicians and Surgeons, and Divisions of Epidemiology (Drs Louis and Schupf) and Biostatistics (Dr Tang), Joseph P. Mailman School of Public Health, Columbia University, New York, NY.

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