Centre for Hip Health & Mobility, University of British Columbia & Vancouver Coastal Health Research Institute (VCHRI), 301-2647 Willow Street, Vancouver, British Columbia, V5Z 3P1, Canada.
BMC Geriatr. 2010 Apr 1;10:16. doi: 10.1186/1471-2318-10-16.
Cognition is a multidimensional construct and to our knowledge, no previous studies have examined the independent contribution of specific domains of cognition to health related quality of life. To determine whether executive functions are independently associated with health related quality of life assessed using Quality Adjusted Life Years (QALYs) calculated from the EuroQol EQ-5D (EQ-5D) in older women after adjusting for known covariates, including global cognition. Therefore, we conducted a secondary analysis of community-dwelling older women aged 65-75 years who participated in a 12-month randomized controlled trial of resistance training. We assessed global cognition using the Mini-Mental State Examination (MMSE) and executive functions using the: 1) Stroop Test; 2) Trail Making Test (Part B) and 3) Digits Verbal Span Backwards Test. We calculated QALYs from the EQ-5D administered at baseline, 6 months and 12 months.
Our multivariate linear regression model demonstrated the specific executive processes of set shifting and working memory, as measured by Trail Making Test (Part B) and Digits Verbal Span Backward Test (p < 0.01) respectively, were independently associated with QALYs after accounting for age, comorbidities, general mobility, and global cognition. The final model explained 50% of the variation in QALYs.
Our study highlights the specific executive processes of set shifting and working memory were independently associated with QALYs -- a measure of health related quality of life. Given that executive functions explain variability in QALYs, clinicians may need to consider assessing executive functions when measuring health related quality of life. Further, the EQ-5D may be used to track changes in health status over time and serve as a screening tool for clinicians.
认知是一个多维结构，据我们所知，以前没有研究检查过认知的特定领域对健康相关生活质量的独立贡献。为了确定在调整了包括整体认知在内的已知协变量后，执行功能是否与使用 EuroQol EQ-5D（EQ-5D）计算的健康相关生活质量（通过质量调整生命年来衡量）独立相关，我们对年龄在 65-75 岁的、参加了为期 12 个月的阻力训练随机对照试验的社区居住的老年女性进行了二次分析。我们使用 Mini-Mental State Examination（MMSE）评估整体认知，使用：1）Stroop 测试；2）Trail Making Test（B 部分）和 3）数字言语回溯测试评估执行功能。我们根据基线、6 个月和 12 个月时的 EQ-5D 评估计算质量调整生命年（QALY）。
我们的多元线性回归模型表明，Trail Making Test（B 部分）和数字言语回溯测试（p < 0.01）分别测量的设定转换和工作记忆等特定执行过程与 QALYs 独立相关，这在考虑了年龄、合并症、一般机动性和整体认知后。最终模型解释了 QALYs 变化的 50%。
我们的研究强调了设定转换和工作记忆等特定执行过程与 QALYs（衡量健康相关生活质量的指标）独立相关。鉴于执行功能可以解释 QALYs 的可变性，临床医生在衡量健康相关生活质量时可能需要考虑评估执行功能。此外，EQ-5D 可用于跟踪随着时间的推移健康状况的变化，并作为临床医生的筛查工具。
