Stijntjes Marjon, Pasma Jantsje H, van Vuuren Marjet, Blauw Gerard Jan, Meskers Carel G M, Maier Andrea B
Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Gerontology. 2015;61(2):124-30. doi: 10.1159/000364916. Epub 2014 Sep 2.
Evidence is emerging that cognitive performance is involved in maintaining balance and thereby involved in falls in the elderly.
To investigate the association of cognitive status with measures of standing balance in elderly outpatients.
In a cross-sectional study, 197 community-dwelling elderly [mean age (SD) 81.9 (7.1) years] referred to a geriatric outpatient clinic were included and subsequently dichotomized into a group with low and normal cognitive status based on cut-off values of the Mini-Mental State Examination, Montreal Cognitive Assessment and Visual Association Test. The ability to maintain standing balance as well as the center of pressure (CoP) movement were assessed during 10 s of side-by-side, semi-tandem and tandem stance with eyes open and eyes closed. Logistic and linear regression were used to examine the association between cognitive status and measures of standing balance adjusted for age, gender and highest completed education.
Low cognitive status in elderly outpatients was associated with a lower ability to maintain 10 s of balance in side-by-side stance with eyes closed [OR (95% CI): 3.57 (1.60; 7.97)] and in semi-tandem stance with eyes open and eyes closed [OR (95% CI): 3.93 (1.71; 9.00) and OR (95% CI): 2.32 (1.11; 4.82), respectively]. Cognitive status was not associated with CoP movement.
Low cognitive status associates with a lower ability to maintain standing balance in more demanding standing conditions in elderly outpatients. This may have implications for routine geriatric screening strategies and interpretation of results of either standing balance or cognitive tests.
越来越多的证据表明，认知能力与维持平衡有关，进而与老年人跌倒有关。
探讨老年门诊患者认知状态与站立平衡指标之间的关联。
在一项横断面研究中，纳入了197名转诊至老年门诊的社区居住老年人[平均年龄（标准差）81.9（7.1）岁]，随后根据简易精神状态检查表、蒙特利尔认知评估量表和视觉联想测试的临界值，将其分为认知状态低和正常两组。在睁眼和闭眼的并排、半串联和串联站立10秒期间，评估维持站立平衡的能力以及压力中心（CoP）的移动情况。采用逻辑回归和线性回归分析，在调整年龄、性别和最高学历后，检验认知状态与站立平衡指标之间的关联。
老年门诊患者认知状态低与闭眼并排站立10秒[比值比（95%置信区间）：3.57（1.60；7.97）]以及睁眼和闭眼半串联站立时维持平衡的能力较低有关[比值比（95%置信区间）：3.93（1.71；9.00）和比值比（95%置信区间）：2.32（1.11；4.82）]。认知状态与CoP移动无关。
在要求更高的站立条件下，老年门诊患者认知状态低与维持站立平衡的能力较低有关。这可能对常规老年筛查策略以及站立平衡或认知测试结果的解释产生影响。
