Scherder Erik, Eggermont Laura, Swaab Dick, van Heuvelen Marieke, Kamsma Yvo, de Greef Mathieu, van Wijck Ruud, Mulder Theo
Institute of Human Movement Sciences, Rijksuniversiteit Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
Neurosci Biobehav Rev. 2007;31(4):485-97. doi: 10.1016/j.neubiorev.2006.11.007. Epub 2007 Feb 15.
The focus of this review is on the close relationship between gait and cognition in ageing and associated dementias. This close relationship is supported by epidemiological studies, clinical studies of older people with and without dementia that focused on the intensity of the physical activity, clinical studies with older persons without dementia examining a relationship between gait and specific cognitive processes, and human and animal experimental studies examining a neural basis for such a relationship. Despite these findings, most studies with patients with dementia focus exclusively on the relationship between cognition and dementia, with relatively few addressing the relationship between gait and dementia. However, subtle disturbances in gait can be observed in ageing and in (preclinical) subtypes of dementia that are not known for prominent motor disturbances, i.e. Mild Cognitive Impairment, Alzheimer's Disease, vascular Cognitive Impairment No Dementia, Subcortical Ischaemic Vascular Dementia, Frontotemporal Mild Cognitive Impairment, and Frontotemporal Dementia, supporting a close relationship between gait and cognition. The relationship between gait and cognition is weakened by the few available intervention studies that examine the effects of walking on cognition in patients with (preclinical) dementia. These studies report equivocal results, which will be discussed. Finally, suggestions for future research will be made.
本综述的重点是衰老及相关痴呆症中步态与认知之间的密切关系。这种密切关系得到了以下研究的支持：流行病学研究、针对有或没有痴呆症的老年人进行的关注身体活动强度的临床研究、针对没有痴呆症的老年人进行的探讨步态与特定认知过程之间关系的临床研究，以及针对这种关系的神经基础进行的人类和动物实验研究。尽管有这些发现，但大多数针对痴呆症患者的研究仅关注认知与痴呆症之间的关系，而涉及步态与痴呆症之间关系的研究相对较少。然而，在衰老以及一些以运动障碍不突出而闻名的（临床前）痴呆症亚型中，即轻度认知障碍、阿尔茨海默病、非痴呆性血管性认知障碍、皮质下缺血性血管性痴呆、额颞叶轻度认知障碍和额颞叶痴呆中，可以观察到步态的细微紊乱，这支持了步态与认知之间的密切关系。少数现有干预研究探讨了步行对（临床前）痴呆症患者认知的影响，这些研究削弱了步态与认知之间的关系。这些研究报告了模棱两可的结果，将对此进行讨论。最后，将对未来研究提出建议。
