Division of Geriatric Medicine, Department of Health Sciences, Lund University, Lund, Sweden.
Clin Interv Aging. 2012;7:195-205. doi: 10.2147/CIA.S31777. Epub 2012 Jul 2.
To investigate whether separate physical tests of the lower extremities, that assess movement speed and postural control, were associated with cognitive impairment in older community-dwelling subjects.
In this population-based, cross-sectional, cohort study, the following items were assessed: walking speed, walking 2 × 15 m, Timed Up and Go (TUG) at self-selected and fast speeds, one-leg standing, and performance in step- and five chair-stand tests. The study comprised 2115 subjects, aged 60-93 years, with values adjusted for demographics, health-related factors, and comorbidity. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE), and cognitive impairment was defined by the three-word delayed recall task of the MMSE. Subjects who scored 0/3 on the three-word delayed recall task were defined as cases (n = 328), those who scored 1/3 were defined as intermediates (n = 457), and the others as controls (n = 1330).
Physical tests performed rapidly were significantly associated with cognitive impairment; this was the case in increased time of five chair stands (P = 0.009, odds ratio [OR] = 1.03), TUG (P < 0.001, OR = 1.11) and walking 2 × 15 m (P < 0.001, OR = 1.05). Inability to stand on one leg for 10 seconds was associated with increased risk of being a case (P < 0.001, OR = 1.78), compared to those able to stand for 30 seconds or longer. More steps during the step test (P < 0.001, OR = 0.95) and higher fast walking speed (P < 0.001, OR = 0.51) were associated with lower risk of being a case.
Slower movements and reduced postural control were related to an increased risk of being cognitively impaired. All tests that were performed rapidly were able to separate cases from controls. These findings suggest that physical tests that are related to lower extremity and postural control, emphasizing velocity, might be useful in investigating relationships between physical and cognitive function; furthermore, they can be used to complement cognitive impairment diagnoses.
探讨下肢运动速度和姿势控制的单独体格检查是否与老年社区居民的认知障碍有关。
在这项基于人群的横断面队列研究中，评估了以下项目：行走速度、行走 2×15m、自主和快速速度的计时起立行走测试（TUG）、单腿站立和台阶及 5 次椅子站立测试的表现。该研究纳入了 2115 名年龄在 60-93 岁的受试者，根据人口统计学、健康相关因素和合并症对结果进行了调整。使用简易精神状态检查（MMSE）评估整体认知功能，MMSE 的三个单词延迟回忆任务得分 0/3 定义为病例（n=328），得分 1/3 定义为中间组（n=457），其他为对照组（n=1330）。
快速进行的体格检查与认知障碍显著相关；在增加 5 次椅子站立的时间（P=0.009，优势比[OR]为 1.03）、TUG（P<0.001，OR=1.11）和行走 2×15m（P<0.001，OR=1.05）方面，情况如此。无法单腿站立 10 秒与病例风险增加相关（P<0.001，OR=1.78），而能够站立 30 秒或更长时间的人则风险较低。在台阶测试中，步数更多（P<0.001，OR=0.95）和快速行走速度更高（P<0.001，OR=0.51）与病例风险降低相关。
运动速度较慢和姿势控制能力下降与认知障碍风险增加相关。所有快速进行的测试都能够将病例与对照组区分开来。这些发现表明，强调速度的与下肢和姿势控制相关的体格检查可能有助于研究身体和认知功能之间的关系；此外，它们可以用于补充认知障碍的诊断。
