Gabel Nicolette M, Crane Natania A, Avery Erich T, Kay Rachel E, Laurent Amanda, Giordani Bruno, Alexander Neil B, Weisenbach Sara L
University of Michigan, Ann Arbor, MI, USA.
University of Illinois at Chicago, Chicago, IL, USA.
Int J Geriatr Psychiatry. 2015 Nov;30(11):1120-8. doi: 10.1002/gps.4340. Epub 2015 Aug 6.
Studies have demonstrated an association between major depressive disorder (MDD) symptoms and fall risk in older adults, which may be at least partially mediated by executive functioning skills. There have also been observations of increased gait variability associated with fall risk and disease. This preliminary study first sought to understand whether gait variability in the context of dual task cost differs among older adults with MDD, relative to those with no history of psychiatric illness, and second, to identify relationships between gait variability measures and cognitive functioning in the context of MDD.
We recruited 15 older adults with MDD and 17 non-depressed (ND) community-dwelling older adults. All participants had impaired balance based on unipedal stance time. Assessments included neuropsychological measures and measures of gait variability using an instrumented gait mat (GAITRite© ) in the context of dual task relative to single task performance (i.e., dual task cost).
The groups did not differ on any gait variability parameters. The MDD group demonstrated poorer performance in the psychomotor speed domain, relative to the ND group, but cognitive functioning between the groups in other domains was equivalent. In MDD, increased variability in stride time, stride velocity, and swing time during dual-tasking were associated with poorer executive functioning and visual memory. In ND, no significant relationships between gait variables and cognitive performance were observed.
Findings suggest that unique cognitive mechanisms underlie mobility problems associated with fall risk in late-life depression.
研究表明,老年人大抑郁障碍(MDD)症状与跌倒风险之间存在关联,这可能至少部分由执行功能技能介导。也有观察发现,步态变异性增加与跌倒风险和疾病有关。这项初步研究首先试图了解,与无精神疾病史的老年人相比,患有MDD的老年人在双重任务成本背景下的步态变异性是否存在差异;其次,确定在MDD背景下步态变异性测量与认知功能之间的关系。
我们招募了15名患有MDD的老年人和17名无抑郁(ND)的社区居住老年人。基于单腿站立时间,所有参与者的平衡能力均受损。评估包括神经心理学测量,以及在双重任务相对于单任务表现(即双重任务成本)的背景下,使用仪器化步态垫(GAITRite©)测量步态变异性。
两组在任何步态变异性参数上均无差异。与ND组相比,MDD组在精神运动速度领域的表现较差,但两组在其他领域的认知功能相当。在MDD中,双重任务期间步幅时间、步幅速度和摆动时间的变异性增加与较差的执行功能和视觉记忆有关。在ND组中,未观察到步态变量与认知表现之间的显著关系。
研究结果表明,独特的认知机制是晚年抑郁症中与跌倒风险相关的行动能力问题的基础。