Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago IL
Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago IL.
J Gerontol A Biol Sci Med Sci. 2015 Oct;70(10):1221-5. doi: 10.1093/gerona/glv062. Epub 2015 May 2.
Loss in physical function is indicative of deterioration in physiological health that may also be associated with deterioration in neurological health. The objective of this study was to examine whether the onset of functional limitations and their severity is associated with increases in cognitive decline among older adults.
The study sample consists of 3825 (65% African Americans and 53% females) participants over the age of 65 with no functional limitations. Cognitive function was assessed using a standardized global cognitive score, and functional limitations using a summary measure of 8 Rosow-Breslau and Nagi limitations (ROS-B/Nagi). Cognitive decline before and after the onset of limitations were analyzed using a linear piecewise change point model.
During follow-up, 2682 (70%) participants reported limitations in ROS-B/Nagi measure. The rate of cognitive decline was 0.053-units per year before any limitations, and increased to 0.069-units per year after one or more limitations in ROS-B/Nagi measure. This was about 30% (95% Confidence Interval [CI]: 18 - 42%) increase in the rate of cognitive decline comparing before and after the onset of limitations in ROS-B/Nagi measure. Also, higher number of limitations in ROS-B/Nagi measure at the time of onset was associated with faster cognitive decline.
The rate of cognitive decline was significantly higher following functional limitations. This study suggests that self-reported measures of functional limitations may serve as an important marker of cognitive decline.
身体功能的丧失表明生理健康恶化，这也可能与神经健康恶化有关。本研究的目的是检验功能障碍的发生及其严重程度是否与老年人认知能力下降的增加有关。
研究样本由 3825 名（65%为非裔美国人，53%为女性）年龄在 65 岁以上、无功能障碍的参与者组成。认知功能采用标准化的总体认知评分进行评估，功能障碍采用 8 项 Rosow-Breslau 和 Nagi 限制（ROS-B/Nagi）的综合衡量标准进行评估。使用线性分段变化点模型分析限制发生前后的认知能力下降情况。
在随访期间，2682 名（70%）参与者报告了 ROS-B/Nagi 测量的限制。在出现任何限制之前，认知能力下降的速度为每年 0.053 个单位，而在出现 ROS-B/Nagi 测量的一个或多个限制后，下降速度增加到每年 0.069 个单位。这意味着在出现 ROS-B/Nagi 测量的限制前后，认知能力下降的速度增加了约 30%（95%置信区间[CI]：18-42%）。此外，在发生 ROS-B/Nagi 测量限制时，ROS-B/Nagi 测量的限制数量越多，认知能力下降的速度越快。
功能障碍后认知能力下降的速度明显加快。本研究表明，自我报告的功能障碍测量指标可能是认知能力下降的一个重要标志物。
