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50至80岁人群中年龄、认知功能和步态表现的相互作用。

Interaction of age, cognitive function, and gait performance in 50-80-year-olds.

作者信息

LaRoche Dain P, Greenleaf Brittnee L, Croce Ronald V, McGaughy Jill A

机构信息

Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA,

出版信息

Age (Dordr). 2014;36(4):9693. doi: 10.1007/s11357-014-9693-5. Epub 2014 Jul 30.

Abstract

The variability of walking gait timing increases with age and is strongly related to fall risk. The purpose of the study was to examine the interaction of age, cognitive function, and gait performance during dual-task walking. Forty-two, healthy men and women, 50-80 years old, completed the Mini-Mental State Exam (MMSE) and Trail Making Test (TMT) to assess cognitive performance and were separated into groups by decade of life. They then performed dual-task walking, at a self-selected pace, on an instrumented treadmill during three cognitive loading conditions: (1) no cognitive load, (2) subtraction from 100 by 1s, and (3) subtraction from 100 by 3s. The treadmill recorded spatiotemporal gait parameters that were used to calculate the mean and coefficient of variation for each variable over ten strides. Time to complete the TMT was positively correlated with age, stride time, double-limb support time, and mediolateral instability and was inversely correlated with single-limb support time. Subjects in their 70s increased their stride time and double-limb support time during the most challenging dual-task condition (subtraction by 3s), whereas subjects in their 50s and 60s did not. Across conditions, the variability of stride length, stride time, and single-limb support time was greatest in the 70s. Mediolateral instability increased only for subjects in their 70s in the subtraction by 3s condition. Reduced cognitive function with age makes it difficult for older adults to maintain a normal, rhythmical gait pattern while performing a cognitive task, which may place them at greater risk for falling.

摘要

行走步态时间的变异性随年龄增长而增加,且与跌倒风险密切相关。本研究的目的是探讨在双任务行走过程中年龄、认知功能和步态表现之间的相互作用。42名年龄在50至80岁之间的健康男性和女性完成了简易精神状态检查表(MMSE)和连线测验(TMT)以评估认知表现,并按年龄段分组。然后,他们在三种认知负荷条件下,以自己选择的速度在装有仪器的跑步机上进行双任务行走:(1)无认知负荷,(2)从100开始每秒减1,(3)从100开始每3秒减1。跑步机记录了时空步态参数,用于计算每个变量在十个步幅上的平均值和变异系数。完成TMT的时间与年龄、步幅时间、双支撑时间和内外侧不稳定性呈正相关,与单支撑时间呈负相关。70多岁的受试者在最具挑战性的双任务条件下(每3秒减1)增加了步幅时间和双支撑时间,而50多岁和60多岁的受试者则没有。在所有条件下,步幅长度、步幅时间和单支撑时间的变异性在70多岁的受试者中最大。仅在70多岁的受试者中,在每3秒减1的条件下,内外侧不稳定性增加。随着年龄增长认知功能下降,使得老年人在执行认知任务时难以维持正常、有节奏的步态模式,这可能使他们面临更大的跌倒风险。

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