Department of Health and Medical Care, National Center for Geriatrics and Gerontology, Aichi, Japan.
Arch Phys Med Rehabil. 2011 Dec;92(12):1992-9. doi: 10.1016/j.apmr.2011.07.195.
To examine whether declining performance in aspects of physical functioning, including lower extremity muscle strength, 1-legged balance, walking speed, and exercise capacity, is associated with atrophy of medial temporal areas in community-dwelling older adults with mild cognitive impairment (MCI).
Cross-sectional study.
General community in Japan.
Community-dwelling older adults 65 years and older with a Clinical Dementia Rating of 0.5 or memory complaints were enrolled in this study. This study examined 34 participants with amnestic MCI (aMCI) and 58 nonamnestic MCI (non-aMCI) participants.
Not applicable.
The following physical performance tests were conducted: muscle strength of knee extension, 1-legged standing time, 5-m walking test, and 6-minute walk test (6MWT). The z scores of the voxel-based specific regional analysis system for Alzheimer's disease were determined to assess the degree of atrophy in the bilateral medial temporal areas including the entorhinal cortex (MTA-ERC).
In the aMCI group, 6MWT performance was associated with MTA-ERC atrophy (β=-.462, P=.014) after controlling for age. In the stepwise multiple regression analyses, 6MWT and body mass index were found to be significant determinants of MTA-ERC atrophy in all participants (R(2)=.275), as well as the aMCI and non-aMCI groups when analyzed separately (R(2)=.418 and R(2)=.216, respectively).
A decline in exercise capacity was found to be more closely associated with atrophy of the MTA-ERC compared with other aspects of physical functioning in older adults with MCI, especially the amnestic type. These findings suggest that it is important for future studies to investigate the effects of increased aerobic activity and improved fitness on brain volume in older adults at risk of developing dementia.
研究在身体功能方面表现出下降趋势的老年人（包括下肢肌肉力量、单腿平衡、行走速度和运动能力），其内侧颞区（medial temporal areas）是否会出现萎缩，这些老年人患有轻度认知障碍（mild cognitive impairment，MCI），且生活在社区。
横断面研究。
日本普通社区。
本研究纳入了认知正常但有记忆主诉的 65 岁及以上的老年人。其中 34 名参与者患有遗忘型轻度认知障碍（amnestic MCI，aMCI），58 名参与者患有非遗忘型轻度认知障碍（non-amnestic MCI，non-aMCI）。
无。
进行了以下身体机能测试：膝关节伸展肌力、单腿站立时间、5 米步行测试和 6 分钟步行测试（6MWT）。采用基于体素的特定区域分析系统（voxel-based specific regional analysis system）对阿尔茨海默病的大脑灰质体积（z 分数）进行了测定，以评估双侧内侧颞区（包括内嗅皮层）的萎缩程度。
在 aMCI 组中，在校正年龄后，6MWT 与 MTA-ERC 萎缩呈显著相关（β=-.462，P=.014）。在逐步多元回归分析中，6MWT 和体重指数是所有参与者 MTA-ERC 萎缩的显著决定因素（R(2)=.275），当分别对 aMCI 和非 aMCI 组进行分析时，其决定因素的解释率分别为 R(2)=.418 和 R(2)=.216。
与其他身体功能方面相比，MCI 老年人的运动能力下降与 MTA-ERC 萎缩的相关性更高，尤其是在遗忘型 MCI 老年人中。这些发现表明，对于未来的研究来说，探究增加有氧运动和改善健康对痴呆风险人群大脑容量的影响是非常重要的。
