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(Stroke. 2005;36:2198.)
© 2005 American Heart Association, Inc.

Original Contributions

Common Carotid Artery Intima-Media Thickness, Carotid Plaques, and Walking Speed

Alexis Elbaz, MD, PhD; Mahaut Ripert, MD; Béatrice Tavernier, MD; Benoît Février, MD; Mahmoud Zureik, MD, PhD; Jérôme Gariépy, MD; Annick Alpérovitch, MD, MSc Christophe Tzourio, MD, PhD

From the INSERM, Unit 708, Paris, France; University Pierre et Marie Curie, Paris (A.E., M.R., A.A., C.T.); 3C Study Center, Dijon, France (B.T., B.F.); INSERM, Unit 508, Lille, France (M.Z.); Centre de Médecine Préventive Cardiovasculaire, Hôpital Broussais, Paris, France (J.G.).

Correspondence to Alexis Elbaz, INSERM Unit 708, 75651 Paris Cedex 13, France. E-mail elbaz{at}chups.jussieu.fr

Background and Purpose— Gait dysfunction is an important cause of disability among the elderly and may be, in part, of vascular origin. We studied the association between carotid ultrasound parameters and measures of gait and balance in subjects 65 to 85 years of age who participated in the baseline phase of the Three-City Study in the Dijon center.

Methods— The study population comprised 2572 noninstitutionalized individuals. Carotid plaques and common carotid artery intima-media thickness (CCA-IMT) were measured using ultrasonography. Gait and balance measures included walking speed and a modified version of the Tinetti scale.

Results— Mean maximum walking speed (MWS) decreased with increasing CCA-IMT and number of plaques (P<10^–4). Compared with subjects in the lowest CCA-IMT quintile, the odds ratio (95% CI) for being in the lowest MWS quartile was 1.1 (0.8 to 1.6) in the second, 1.3 (0.9 to 1.8) in the third, 1.7 (1.2 to 2.4) in the fourth, and 2.2 (1.6 to 3.1) in the higher CCA-IMT quintile (P<10^–4). Mean (SD) CCA-IMT was 0.716 (0.118) mm in subjects with a modified Tinetti score <16 (25th percentile) and 0.685 (0.109) mm in subjects with a score of 16 (P=0.006). The proportion of subjects in the lowest MWS quartile (P=0.006) or with a modified Tinetti score <16 (P=0.05) increased with the number of plaques. These relations were attenuated after adjustment for vascular risk factors.

Conclusions— Carotid plaques and higher CCA-IMT values are associated with worse performances on gait and balance tests. Our results suggest that vascular factors may play an important and under-recognized role in motor function.

Key Words: epidemiology • gait • intima-media thickness • motor activity • ultrasonography

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