Association of vitamin B-12, 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 B-12. 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 B-12, 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 B-12 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 B-12 (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 B-12 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 B-12 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.