Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Tōn City, Japan.
Dement Geriatr Cogn Disord. 2010;29(5):379-87. doi: 10.1159/000255106. Epub 2010 May 20.
BACKGROUND/AIMS: Mobility impairment in older adults has been suggested to be a marker of subclinical structural and functional brain abnormalities. We investigated a possible association between static postural instability and brain abnormalities and cognitive decline.
The study subjects were 390 community residents without definitive dementia (67 +/- 7 years old) and 21 patients with Alzheimer's disease (AD). Brain atrophy was measured by MRI.
The mobility of the posturography-measured center of gravity (COG) was positively associated with the temporal horn area (THA; r = 0.260; p < 0.001). Subjects who could not stand on one leg for >40 s (n = 102) showed a significantly larger THA (22 +/- 18 vs. 14 +/- 11 x 10(-2) cm(2); p < 0.001). Multiple regression analysis identified COG path length (beta = 0.118; p = 0.032) and one-leg standing time (beta = 0.176; p = 0.001) as independent determinants of THA. Mild cognitive impairment (MCI) subjects (n = 61) had a significantly enlarged THA compared to that of normal cognitive subjects (22 +/- 16 vs. 16 +/- 13 x 10(-2) cm(2); p = 0.002). AD patients showed a more enlarged THA (78 +/- 55 x 10(-2) cm(2)). Subjects with cognitive decline showed a significantly shorter one-leg standing time (normal: 50 +/- 17 s; MCI: 42 +/- 21 s; AD: 18 +/- 20s; p < 0.001).
Reduced postural stability was an independent marker of brain atrophy and pathological cognitive decline in the elderly.
背景/目的：老年人的行动障碍被认为是亚临床结构和功能脑异常的标志。我们研究了静态姿势不稳与脑异常和认知能力下降之间的可能关联。
研究对象为 390 名无明确痴呆症的社区居民（67 ± 7 岁）和 21 名阿尔茨海默病（AD）患者。通过 MRI 测量脑萎缩。
平衡仪测量的重心（COG）的移动性与颞角面积（THA）呈正相关（r = 0.260；p < 0.001）。无法单腿站立超过 40 秒的受试者（n = 102）THA 明显较大（22 ± 18 与 14 ± 11 x 10(-2) cm(2)；p < 0.001）。多元回归分析确定 COG 路径长度（β = 0.118；p = 0.032）和单腿站立时间（β = 0.176；p = 0.001）是 THA 的独立决定因素。轻度认知障碍（MCI）受试者（n = 61）THA 明显大于正常认知受试者（22 ± 16 与 16 ± 13 x 10(-2) cm(2)；p = 0.002）。AD 患者的 THA 更大（78 ± 55 x 10(-2) cm(2)）。认知能力下降的受试者单腿站立时间明显缩短（正常：50 ± 17 s；MCI：42 ± 21 s；AD：18 ± 20s；p < 0.001）。
姿势稳定性降低是老年人脑萎缩和病理性认知能力下降的独立标志物。
