Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Geriatr Gerontol Int. 2013 Apr;13(2):437-42. doi: 10.1111/j.1447-0594.2012.00927.x. Epub 2012 Aug 31.
Falls are common in patients with cognitive disorder. The purpose of this study was to determine whether global brain atrophy is associated with cognitive function, physical performance and fall incidents in older adults with mild cognitive disorder.
A total of 31 older adults with mild cognitive disorders (mean age 78.9 ± 7.3 years) were studied, and 10 of them had experienced falls and the others had not in the past 1 year. Cognitive function and physical performance were measured in these patients. Global brain atrophy was determined by the Voxel-Based Specific Regional Analysis System for Alzheimer's Disease software.
Fallers showed significantly worse scores than the non-fallers in the Global Brain Atrophy Index, Clock Drawing Test (CDT), Verbal Fluency Test (animal), maximum walking time and Timed Up & Go (TUG) Test. The Global Brain Atrophy Index was correlated with the Verbal Fluency Test (animal; r = -0.522), the Verbal Fluency Test with letter (ka; r = -0.337), CDT (r = -0.547), TUG (r = 0.276) and Five Chair Stands Test (r = 0.303) by age-adjusted correlation analyses. Stepwise regression analysis showed that the Global Brain Atrophy Index (β = 1.265, 95% CI 1.022-1.567) was a significant and independent determinant of falls (R(2) = 0.356, P = 0.003).
Global brain atrophy might be indicated as one of the risk factors for falls in older adults with mild cognitive disorders.
认知障碍患者常发生跌倒。本研究旨在确定轻度认知障碍老年人的全脑萎缩是否与认知功能、身体机能和跌倒事件有关。
共纳入 31 例轻度认知障碍老年人(平均年龄 78.9±7.3 岁),其中 10 例有跌倒史,其余 21 例在过去 1 年内无跌倒史。对这些患者进行认知功能和身体机能测试。使用基于体素的特定区域分析系统(Voxel-Based Specific Regional Analysis System for Alzheimer's Disease software)测定全脑萎缩。
与无跌倒史者相比,跌倒者的全脑萎缩指数、画钟试验(CDT)、词语流畅性测验(动物)、最大步行时间和计时起立行走试验(TUG)的评分显著更差。全脑萎缩指数与词语流畅性测验(动物;r=-0.522)、词语流畅性测验(字母 ka;r=-0.337)、CDT(r=-0.547)、TUG(r=0.276)和 5 次椅子站立试验(r=0.303)呈负相关,经年龄校正的相关分析显示。逐步回归分析显示,全脑萎缩指数(β=1.265,95%可信区间 1.022-1.567)是老年人发生跌倒的一个显著独立预测因素(R²=0.356,P=0.003)。
全脑萎缩可能是轻度认知障碍老年人跌倒的危险因素之一。