Di Iorio Angelo, Abate Michele, Pini Barbara, Di Nicola Isabella, Marinelli Marianna, Guglielmi Marianna, Battaglini Corrado, Abate Giuseppe
Laboratory of Clinical Epidemiology and Geriatrics, Department of Medicine and Sciences of Aging, University G. d'Annunzio, Chieti, Via dei Vestini 5, 66013 Chieti Scalo, Italy.
Aging Clin Exp Res. 2009 Apr;21(2):136-42. doi: 10.1007/BF03325221.
The purpose of this study was to evaluate the effects of vascular risk factors, isolated or in association, on balance, as assessed by posturographic platform.
One hundred and seven elderly subjects (mean age 73.8+/-5.8), with no cognitive impairment (MMSE>24), able to perform self-care activities and to walk independently for at least 400 meters, free from major diseases. Subjective complaints were assessed by means of the Sickness Impact Profile Questionnaire. The following cardiovascular risk factors were considered: hypercholesterolemia, smoking, hypertension, glucose intolerance, and obesity. Balance tests were performed in three standardized positions (side-by-side, semi-tandem, tandem) on a vertical force platform, from which center of foot pressure positions and displacements were recorded.
A large percentage of enrolled subjects (35.5%) complained of unsteadiness, dizziness or vertigo, but only a few (24=22.4%) reported at least one fall in the 6 months before enrolment in the study. Among the cardiovascular risk factors taken into account, only glucose intolerance and, to a lesser extent, obesity, were associated with worse performance in stabilometric tests, independent of age and sex. Subjects with 3 or more risk factors, compared with those with 2 or less showed worse performance in medio-lateral sway (p=0.001), track length (p=0.05) and elliptical area (p=0.005), in tandem position.
The cumulative presence of cardiovascular risk factors may contribute to impairment of balance in the elderly. This effect may be due to subclinical damage of that part of the nervous system controlling balance.
本研究旨在评估血管危险因素单独或联合存在时,对通过姿势描记平台评估的平衡能力的影响。
107名老年受试者(平均年龄73.8±5.8岁),无认知障碍(简易精神状态检查表得分>24),能够进行自我护理活动且能独立行走至少400米,无重大疾病。通过疾病影响概况问卷评估主观症状。考虑以下心血管危险因素:高胆固醇血症、吸烟、高血压、葡萄糖耐量异常和肥胖。在垂直力平台上以三种标准化姿势(并排、半串联、串联)进行平衡测试,记录足底压力中心位置和位移。
很大比例(35.5%)的入选受试者主诉步态不稳、头晕或眩晕,但只有少数(24名,占22.4%)报告在入选研究前6个月内至少有一次跌倒。在所考虑的心血管危险因素中,只有葡萄糖耐量异常以及程度较轻的肥胖与静态平衡测试中的较差表现相关,且与年龄和性别无关。与有2种或更少危险因素的受试者相比,有3种或更多危险因素的受试者在串联姿势下的左右摇摆(p = 0.001)、轨迹长度(p = 0.05)和椭圆面积(p = 0.005)方面表现更差。
心血管危险因素的累积存在可能导致老年人平衡能力受损。这种影响可能是由于控制平衡的神经系统部分受到亚临床损伤所致。