Intrinsic Capacity Declines with Elevated Homocysteine in Community-Dwelling Chinese Older Adults

Intrinsic capacity (IC) reflects the overall health status of older adults and has great public health significance. But few studies described the related biomarkers for IC. The aim of this study was to investigate the association between homocysteine (Hcy) and IC in older adults.

This cross-sectional study included 1927 community-dwelling Chinese older adults aged 60-98 years from May 2020 to December 2020. Data were collected through interviews, physical examinations, and laboratory tests. IC involved five domains of cognition, locomotion, sensory, vitality, and psychology evaluated by the Mini-cog scale, 4-m walk test, self-reported visual and hearing conditions, MNA-SF scale, and GDS-4 scale, respectively. The score of each domain dichotomized as 0 (normal) and 1 (impaired) was added together to an IC total score. Low IC was defined as a score of 3-5, and high IC as 0-2. Hcy was measured by a two-reagent enzymatic assay. A restricted cubic spline regression model was used to explore the non-linear relationship between Hcy and low IC.

Hcy was higher in the low IC group than in the high IC group. Restricted cubic spline analysis revealed a J-shaped nonlinear association between Hcy and low IC. The risk of IC decline was slowly decreased until 8.53 µmol/L of Hcy (OR=0.753, 95% CI=0.520-1.091, P=0.132), and increased with elevations of per 5 µmol/L Hcy afterwards (OR=1.176, 95% CI=1.059-1.327, P=0.005). Among the five domains of IC, Hcy had ORs of 1.116 (1.009-1.247) for cognition impairment, 1.167 (1.055-1.305) for vitality, and 1.160 (1.034-1.303) for psychology per 5 µmol/L increase in Hcy above the change point. Additional sensitivity analysis also demonstrated the nonlinear association between Hcy and low IC.

Hcy had a J-shaped association with low IC. Higher Hcy (Hcy ≥8.53µmol/L) might provide clinical implications for early identifying the risk of low IC.