Ferreira Naomi Vidal, Cunha Paulo Jannuzzi, da Costa Danielle Irigoyen, dos Santos Fernando, Costa Fernando Oliveira, Consolim-Colombo Fernanda, Irigoyen Maria Cláudia
Heart Institute, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
Neuroimaging in Psychiatry Laboratory, Department of Psychiatry, Medical School, Universidade de São Paulo, São Paulo, SP, Brazil.
Clin Interv Aging. 2015 May 6;10:839-46. doi: 10.2147/CIA.S69270. eCollection 2015.
Peripheral arterial disease, as measured by the ankle-brachial index (ABI), is prevalent among the elderly, and is associated with functional performance, assessed by the 6-minute walk test (6MWT). Executive cognitive function (ECF) impairments are also prevalent in this population, but no existing study has investigated the association between ECF and functional performance in an elderly population including individuals with low ABI.
To investigate the association between functional performance, as measured by the 6MWT, and loss in ECF, in an elderly sample including individuals with low ABI.
The ABI group was formed by 26 elderly individuals with low ABI (mean ABI: 0.63±0.19), and the control group was formed by 40 elderly individuals with normal ABI (mean ABI: 1.08±0.07). We analyzed functional performance using the 6MWT, global cognition using the Mini-Mental State Examination (MMSE), and ECF using the Digit Span for assessing attention span and working memory, the Stroop Color Word Test (SCWT) for assessing information processing speed and inhibitory control/impulsivity, and the Controlled Oral Word Association Test (COWAT) for assessing semantic verbal fluency and phonemic verbal fluency. We also used a factor analysis on all of the ECF tests (global ECF).
Before adjustment, the ABI group performed worse on global cognition, attention span, working memory, inhibitory control/impulsivity, semantic verbal fluency, and phonemic verbal fluency. After adjustment, the ABI group performance remained worse for working memory and semantic verbal fluency. In a simple correlation analysis including all of the subjects, the 6MWT was associated with global cognition, attention span, working memory, information processing speed, inhibitory control/impulsivity, semantic verbal fluency, and global ECF. After adjustment, all the associations remained statistically significant.
This study found an independent association between functional performance and ECF in an elderly population including low ABI individuals, showing that, in elderly populations with functional impairment, ECF may also be impaired.
通过踝臂指数（ABI）测量的外周动脉疾病在老年人中普遍存在，并且与通过6分钟步行试验（6MWT）评估的功能表现相关。执行认知功能（ECF）障碍在该人群中也很普遍，但现有研究均未调查ECF与包括低ABI个体在内的老年人群功能表现之间的关联。
在包括低ABI个体的老年样本中，研究通过6MWT测量的功能表现与ECF丧失之间的关联。
ABI组由26名低ABI的老年人组成（平均ABI：0.63±0.19），对照组由40名ABI正常的老年人组成（平均ABI：1.08±0.07）。我们使用6MWT分析功能表现，使用简易精神状态检查表（MMSE）分析整体认知，使用数字广度测试评估注意力广度和工作记忆、使用斯特鲁普颜色词测试（SCWT）评估信息处理速度和抑制控制/冲动性、使用受控口语联想测试（COWAT）评估语义言语流畅性和音素言语流畅性来分析ECF。我们还对所有ECF测试进行了因子分析（整体ECF）。
调整前，ABI组在整体认知、注意力广度、工作记忆、抑制控制/冲动性、语义言语流畅性和音素言语流畅性方面表现较差。调整后，ABI组在工作记忆和语义言语流畅性方面的表现仍然较差。在包括所有受试者的简单相关性分析中，6MWT与整体认知、注意力广度、工作记忆、信息处理速度、抑制控制/冲动性、语义言语流畅性和整体ECF相关。调整后，所有关联仍具有统计学意义。
本研究在包括低ABI个体的老年人群中发现了功能表现与ECF之间的独立关联，表明在有功能障碍的老年人群中，ECF也可能受损。
