Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA.
J Gerontol A Biol Sci Med Sci. 2013 Aug;68(8):929-37. doi: 10.1093/gerona/gls256. Epub 2012 Dec 18.
The association between gait speed and cognition has been reported; however, there is limited knowledge about the temporal associations between gait slowing and cognitive decline among cognitively normal individuals.
The Mayo Clinic Study of Aging is a population-based study of Olmsted County, Minnesota, United States, residents aged 70-89 years. This analysis included 1,478 cognitively normal participants who were evaluated every 15 months with a nurse visit, neurologic evaluation, and neuropsychological testing. The neuropsychological battery used nine tests to compute domain-specific (memory, language, executive function, and visuospatial skills) and global cognitive z-scores. Timed gait speed (m/s) was assessed over 25 feet (7.6 meters) at a usual pace. Using mixed models, we examined baseline gait speed (continuous and in quartiles) as a predictor of cognitive decline and baseline cognition as a predictor of gait speed changes controlling for demographics and medical conditions.
Cross-sectionally, faster gait speed was associated with better performance in memory, executive function, and global cognition. Both cognitive scores and gait speed declined over time. A faster gait speed at baseline was associated with less cognitive decline across all domain-specific and global scores. These results were slightly attenuated after excluding persons with incident mild cognitive impairment or dementia. By contrast, baseline cognition was not associated with changes in gait speed.
Our study suggests that slow gait precedes cognitive decline. Gait speed may be useful as a reliable, easily attainable, and noninvasive risk factor for cognitive decline.
已有研究报道步态速度与认知之间存在关联；然而，对于认知正常个体中步态减慢与认知下降之间的时间关联，我们的了解还很有限。
梅奥诊所老龄化研究是一项针对美国明尼苏达州奥姆斯特德县的基于人群的研究，研究对象为年龄在 70-89 岁的居民。本分析包括 1478 名认知正常的参与者，他们每 15 个月接受一次护士访视、神经学评估和神经心理学测试。使用的神经心理学测试包包含 9 项测试，用于计算特定领域（记忆、语言、执行功能和视空间技能）和总体认知的 z 分数。使用 25 英尺（7.6 米）的距离评估定时步速（米/秒），以正常速度进行。使用混合模型，我们检查了基线步速（连续和四分位数）作为认知下降的预测指标，以及基线认知作为控制人口统计学和医疗状况的步态速度变化的预测指标。
横向比较时，较快的步速与记忆、执行功能和总体认知的更好表现相关。认知评分和步速随时间推移而下降。基线时较快的步速与所有特定领域和总体评分的认知下降减少相关。这些结果在排除有新发轻度认知障碍或痴呆的患者后略有减弱。相比之下，基线认知与步态速度的变化无关。
我们的研究表明，缓慢的步态先于认知下降。步态速度可能是认知下降的一个可靠、易于获得且非侵入性的风险因素。
