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轻度认知障碍和步态缓慢的老年人的认知功能与跌倒情况

Cognitive function and falling among older adults with mild cognitive impairment and slow gait.

作者信息

Doi Takehiko, Shimada Hiroyuki, Park Hyuntae, Makizako Hyuma, Tsutsumimoto Kota, Uemura Kazuki, Nakakubo Sho, Hotta Ryo, Suzuki Takao

机构信息

Department of Functioning Activation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.

Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.

出版信息

Geriatr Gerontol Int. 2015 Aug;15(8):1073-8. doi: 10.1111/ggi.12407. Epub 2014 Nov 3.

Abstract

AIM

To examine the association of the combination of slow gait and mild cognitive impairment (MCI) with cognitive function and falling in community-dwelling older people.

METHODS

Participants were selected from the Obu Study of Health Promotion for the Elderly (n = 3400), and underwent gait examination and a battery of neuropsychological examinations, including the Mini-Mental State Examination and the National Center for Geriatrics and Gerontology Functional Assessment Tool (tablet version of Trail Making Test Part A and B, Symbol Digit Substitution Task, Figure selection task, Word memory and Story memory), and were interviewed with a series of questionnaires including medical history, physical activity, geriatric depression scale and fall history.

RESULTS

Participants were classified into control (n = 2281), slow gait speed (SG; n = 278), MCI (n = 673) and MCI with SG (MCI+SG; n = 168) groups. All cognitive functions were significantly affected by the group factor, even adjusting for participant characteristics as covariates (P < 0.001). Post-hoc analysis showed that the control group had better performance than the other groups, and the MCI+SG group had worse performance than the other groups in all cognitive functions (all P < 0.05). In multiple logistic regression analysis, SG and MCI were independently associated with falling (all P < 0.05), and MCI+SG had a higher odds ratio for falling (adjusted OR 1.99, 95% CI 1.08-3.65).

CONCLUSIONS

Our findings support the idea that slow gait and MCI were related, and concurrently associated with falling. Motor function among MCI subjects should be focused on to assess profile risks.

摘要

目的

探讨社区居住老年人中步态缓慢与轻度认知障碍(MCI)的组合与认知功能及跌倒之间的关联。

方法

参与者选自大府老年人健康促进研究(n = 3400),接受了步态检查和一系列神经心理学检查,包括简易精神状态检查表以及国立老年医学和老年学中心功能评估工具(连线测验A和B的平板电脑版、符号数字替换测验、图形选择任务、单词记忆和故事记忆),并通过一系列问卷进行访谈,内容包括病史、身体活动、老年抑郁量表和跌倒史。

结果

参与者被分为对照组(n = 2281)、步态速度缓慢(SG;n = 278)、MCI(n = 673)和伴有SG的MCI(MCI+SG;n = 168)组。即使将参与者特征作为协变量进行调整,所有认知功能仍受到组因素的显著影响(P < 0.001)。事后分析表明,对照组在所有认知功能方面的表现均优于其他组,而MCI+SG组在所有认知功能方面的表现均比其他组差(所有P < 0.05)。在多因素logistic回归分析中,SG和MCI与跌倒独立相关(所有P < 0.05),且MCI+SG发生跌倒的比值比更高(调整后的OR为1.99,95%CI为1.08 - 3.65)。

结论

我们的研究结果支持步态缓慢与MCI相关且同时与跌倒有关的观点。应关注MCI受试者的运动功能以评估潜在风险。

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