International Journal of Neuroscience, 123, 24–30, 2013 Copyright © 2013 Informa Healthcare USA, Inc. ISSN: 0020-7454 print / 1543-5245 online DOI: 10.3109/00207454.2012.722570 Biological Determinants of Postural Disorders in Elderly Women Alexis Lion, 1,2 Rosario S. Spada, 2 Gilles Bosser, 1,3,4 G´ erome C. Gauchard, 1,3 Guido Anello, 2 Paolo Bosco, 2 Santa Calabrese, 2 Antonella Iero, 2 Giuseppe Stella, 2 Maurizio Elia, 2 and Philippe P. Perrin 1,3,5 1 INSERM U954, Nutrition-G´ en´ etique et Exposition aux Risques Environnementaux, Faculty of Medicine, Vandoeuvre-l` es-Nancy, France 2 IRCCS Associazione Oasi Maria SS, Institute for Research on Mental Retardation and Brain Aging, Troina, Italy 3 Universit´ e de Lorraine, Balance Control and Motor Performance (EPM), UFR STAPS, Villers-l` es-Nancy, France 4 Department of Cardiac Rehabilitation, Regional Institute for Rehabilitation (IRR), University Hospital, Vandoeuvre-l` es-Nancy, France 5 Department of Oto-Rhino-Laryngology, University Hospital, Vandoeuvre-l` es-Nancy, France ABSTRACT Postural control impairments and dizziness, which are major health problems with high secondary morbidity and mortality, increase with aging. Elevated homocysteine (Hcy) level is an age-related metabolic disorder, known to be involved in cardiovascular, neurological, and multisensory dysfunctions. Elevated Hcy level might be involved in sensory balance control systems impairment and dizziness occurrence. Dizziness, itness Instrumental Ac- tivity of Daily Living scale (itness IADL), systolic arterial pressure with ankle-brachial blood pressure index and homocysteinemia were studied in 61 noninstitutionized elderly women. Clinical balance tests (timed “Up and Go”, 10-m walking and one-leg balance) and posturography (including sensory conlicting situations [SCS] and cognitive conlicting situations [CCS]) were performed. Clinical balance control was lower in dizzy women who presented particularly poor stability in SCS. Dizziness was related to low itness IADL scores (odds ratio [OR] 0.452, 95% CI 0.216–0.946) and to elevated Hcy (OR 8.084, 95% CI 1.992–32.810). Elevated Hcy was correlated with balance disorders both in SCS and CCS. Dizziness is associated with a reduced ability in balance control management. Hcy is related both to dizziness and low postural performance. This relation between elevated Hcy levels and balance impairments, resulting in dizziness, may be explained by its angiotoxicity and neurotoxicity. KEYWORDS: aging, angiotoxicity, balance control, dizziness, homocysteine, neurotoxicity INTRODUCTION Aging leads to a decrease in sensitivity of vestibular, vi- sual and somatokinesthetic receptors, in eficiency of central information processing, and in quality of mus- cular effectors [1]. These age-related modiications at all levels of balance regulation may induce postural con- Received 20 June 2012. “Professor Jean-Louis Gu´ eant contributed to the study design and to the data analysis.” Address correspondence to Prof. Philippe P. Perrin, MD, PhD, Equilibration et Performance Motrice, UFR STAPS de Nancy, Universit´ e de Lorraine, 30 rue du Jardin Botanique, 54600 Villers-l` es-Nancy, France. E-mail: philippe.perrin@univ-lorraine.fr trol alteration leading possibly to falls which represent one of the main causes of longstanding pain, functional impairment, disability, and death in elderly people [2]. Although we already know that the practice of physical activities limits the age-related alteration of postural control [3], the complementary understanding of the mechanisms and the risk factors of postural control im- pairments still remains of public health concern. Aging is also related to an increased occurrence of dizziness and this symptom may therefore limit the physical and social activities of the older adults [4]. Dizziness, which is an unspeciic symptom including light-headedness, unsteadiness, motion intolerance, imbalance, loating, or a tilting sensation, is particularly associated with falls [5]. Indeed, 30% of people over 65 fall at least once 24 Int J Neurosci Downloaded from informahealthcare.com by INSERM on 12/30/12 For personal use only.