Holtzer Roee, Friedman Rachel, Lipton Richard B, Katz Mindy, Xue Xiaonan, Verghese Joe
Ferkauf Graduate School of Psychology, Albert Einstein College of Medicine, Yeshiva University, NY 10461, USA.
Neuropsychology. 2007 Sep;21(5):540-8. doi: 10.1037/0894-4105.21.5.540.
The current study examined the relationship between cognitive function and falls in older people who did not meet criteria for dementia or mild cognitive impairment (N = 172). To address limitations of previous research, the authors controlled for the confounding effects of gait measures and other risk factors by means of associations between cognitive function and falls. A neuropsychological test battery was submitted to factor analysis, yielding 3 orthogonal factors (Verbal IQ, Speed/Executive Attention, Memory). Single and recurrent falls within the last 12 months were evaluated. The authors hypothesized that Speed/Executive Attention would be associated with falls. Additionally, the authors assessed whether associations between different cognitive functions and falls varied depending on whether single or recurrent falls were examined. Multivariate logistic regressions showed that lower scores on Speed/Executive Attention were associated with increased risk of single and recurrent falls. Lower scores on Verbal IQ were related only to increased risk of recurrent falls. Memory was not associated with either single or recurrent falls. These findings are relevant to risk assessment and prevention of falls and point to possible shared neural substrates of cognitive and motor function.
本研究调查了不符合痴呆或轻度认知障碍标准的老年人(N = 172)的认知功能与跌倒之间的关系。为解决先前研究的局限性,作者通过认知功能与跌倒之间的关联,控制了步态测量和其他风险因素的混杂效应。对一套神经心理测试进行了因子分析,得出3个正交因子(言语智商、速度/执行注意力、记忆)。评估了过去12个月内的单次跌倒和反复跌倒情况。作者假设速度/执行注意力与跌倒有关。此外,作者评估了不同认知功能与跌倒之间的关联是否因检查的是单次跌倒还是反复跌倒而有所不同。多变量逻辑回归显示,速度/执行注意力得分较低与单次跌倒和反复跌倒风险增加有关。言语智商得分较低仅与反复跌倒风险增加有关。记忆与单次跌倒或反复跌倒均无关联。这些发现与跌倒的风险评估和预防相关,并指出了认知和运动功能可能共享的神经基质。