Celle Sébastien, Annweiler Cédric, Camicioli Richard, Barthélémy Jean-Claude, Roche Frédéric, Beauchet Olivier
Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, 49933 Angers, Cedex 9, France.
BMC Pulm Med. 2014 Aug 23;14:140. doi: 10.1186/1471-2466-14-140.
Sleep-related breathing disorders (SRBDs) provoke cognitive and structural brain disorders. Because these disorders have been associated with unsafe gait characterized by an increase in stride-to-stride variability of stride time (STV), we hypothesised that SRBDs could be associated with an increased STV. The aim of this study was to examine the association between SRBDs and STV in French healthy older community-dwellers.
A total of 49 participants (mean age 69.6 ± 0.8 years; 65.2% female) were included in this cross-sectional study. All participants, who were free of clinically diagnosed SRBDs before their inclusion, had a nocturnal unattended home-sleep assessment. There were separated in three group based on apnea + hypopnea index (AHI): AHI <15 defining the absence of SRBD, AHI between 15-30 defining mild SRBD, and AHI >30 defining moderate-to-severe SRBD. Coefficient of variation of stride time, which is a measure of STV, was recorded while usual walking using SMTEC® footswitches system. Digit span score was used as a measure of executive performance. Age, gender, body mass index (BMI), number of drugs daily taken, vision, proprioception, history of falls, depression symptoms, global cognitive functioning were also recorded.
STV and BMI were higher in participants with mild SRBDs (P = 0.031 and P = 0.020) and moderate-to-severe SRBDs (P = 0.004 and P = 0.002) compared to non-SRBDs. STV positively correlated with AHI (P = 0.036). Lower (i.e., better) STV was associated with the absence of SRBDs (P = 0.021), while greater (i.e., worse) STV was associated with moderate-to-severe SRBD (P < 0.045) but not with mild SRBD (P > 0.06).
Our results show a positive association between STV and SRBDs, with moderate-to-severe SRBD being associated with greater gait variability. This association opens new perspectives for understanding gait disorders in older adults with SRBDs and opens the door to treatments options since SRBDs are potential treatable factors.
睡眠相关呼吸障碍（SRBDs）会引发认知和脑部结构紊乱。由于这些障碍与不安全步态有关，其特征为步幅时间（STV）的逐步步幅变异性增加，我们推测SRBDs可能与STV增加有关。本研究的目的是调查法国健康老年社区居民中SRBDs与STV之间的关联。
本横断面研究共纳入49名参与者（平均年龄69.6±0.8岁；65.2%为女性）。所有参与者在纳入研究前均无临床诊断的SRBDs，进行了夜间无人值守的家庭睡眠评估。根据呼吸暂停低通气指数（AHI）分为三组：AHI<15定义为无SRBDs，AHI在15-30之间定义为轻度SRBDs，AHI>30定义为中度至重度SRBDs。使用SMTEC®脚踏开关系统在日常行走时记录步幅时间的变异系数，这是一种衡量STV的指标。数字广度得分用作执行能力的衡量指标。还记录了年龄、性别、体重指数（BMI）、每日服用药物数量、视力、本体感觉、跌倒史、抑郁症状、整体认知功能。
与无SRBDs的参与者相比，轻度SRBDs（P=0.031和P=0.020）和中度至重度SRBDs（P=0.004和P=0.002）的参与者STV和BMI更高。STV与AHI呈正相关（P=0.036）。较低（即较好）的STV与无SRBDs相关（P=0.021），而较高（即较差）的STV与中度至重度SRBD相关（P<0.045），但与轻度SRBD无关（P>0.06）。
我们的结果显示STV与SRBDs之间存在正相关，中度至重度SRBD与更大的步态变异性相关。这种关联为理解患有SRBDs的老年人的步态障碍开辟了新的视角，并且由于SRBDs是潜在的可治疗因素，也为治疗选择打开了大门。
