血清维生素 D 状况与 65 岁及以上记忆门诊患者的功能性移动能力之间的关联。
Association between serum vitamin D status and functional mobility in memory clinic patients aged 65 years and older.
机构信息
Basel Mobility Center, Department of Acute Geriatrics, University Hospital Basel, Basel, Switzerland.
出版信息
Gerontology. 2014;60(2):123-9. doi: 10.1159/000355667. Epub 2013 Dec 7.
BACKGROUND
Recent studies have shown that vitamin D status may be relevant for physical and cognitive performance in the older population. This association may be of particular interest to older people at risk for cognitive impairment and functional decline.
OBJECTIVE
The aim of this study was to determine the association between serum 25-hydroxyvitamin D [25(OH)D] status and functional mobility in seniors assessed in a memory clinic.
METHODS
We conducted a cross-sectional study of outpatients (n = 404) in a memory clinic. Functional mobility was assessed with three endpoints: normal and fast walking speed and the Timed Up and Go (TUG) test. Adjusted multivariate analyses in all patients and two pre-planned subgroup analyses in vulnerable seniors (previous fall and MMSE score of ≥26 or no previous fall and MMSE score of <26) versus less vulnerable seniors (no previous fall and MMSE score of ≥26) were performed to assess the association of 25(OH)D and functional mobility.
RESULTS
Overall, mean 25(OH)D serum levels were 63.2 ± 33.9 nmol/l, and 41.3% were vitamin D deficient (<50 nmol/l). Seniors in the lowest 25(OH)D quartile (<39 nmol/l) had significantly worse functional mobility compared to the highest 25(OH)D quartile (>81 nmol/l); adjusted for all covariates, seniors in the highest quartile performed 9.4% better in normal (p = 0.02) and 9.2% better in fast (p = 0.004) walking speed, and 4.4% better in the TUG test (p = 0.24). The association between 25(OH)D status and functional mobility was most pronounced in less vulnerable seniors (p for trend significant for all three mobility tests). Seniors with a higher 25(OH)D status also had better cognitive function (MMSE score; p = 0.006).
CONCLUSIONS
Lower serum 25(OH)D status is associated with poorer functional mobility and cognitive function, therefore supporting 25(OH)D assessment in this population at risk for both functional and cognitive decline.
背景
最近的研究表明,维生素 D 状况可能与老年人的身体和认知表现有关。对于有认知障碍和功能下降风险的老年人来说,这种关联可能特别重要。
目的
本研究旨在确定血清 25-羟维生素 D [25(OH)D]状况与在记忆诊所评估的老年人的功能性移动能力之间的关系。
方法
我们对记忆诊所的门诊患者(n=404)进行了横断面研究。功能性移动能力通过三个终点来评估:正常和快速行走速度以及计时起立行走(TUG)测试。对所有患者进行调整后的多变量分析,并在易受影响的老年人(既往跌倒和 MMSE 评分≥26 或无既往跌倒和 MMSE 评分<26)和不易受影响的老年人(无既往跌倒和 MMSE 评分≥26)中进行了两次预设的亚组分析,以评估 25(OH)D 和功能性移动能力之间的关联。
结果
总体而言,平均 25(OH)D 血清水平为 63.2±33.9 nmol/L,41.3%的患者维生素 D 缺乏(<50 nmol/L)。25(OH)D 最低四分位数(<39 nmol/L)的老年人的功能性移动能力明显差于 25(OH)D 最高四分位数(>81 nmol/L);调整所有协变量后,最高四分位数的老年人在正常行走(p=0.02)和快速行走(p=0.004)速度方面的表现分别提高了 9.4%和 9.2%,在 TUG 测试中提高了 4.4%(p=0.24)。25(OH)D 状态与功能性移动能力之间的关联在不易受影响的老年人中最为显著(所有三种移动能力测试的趋势检验均有显著意义)。25(OH)D 状态较高的老年人的认知功能也更好(MMSE 评分;p=0.006)。
结论
血清 25(OH)D 水平较低与较差的功能性移动能力和认知功能有关,因此支持对有功能和认知下降风险的这一人群进行 25(OH)D 评估。