Varma Vijay R, Hausdorff Jeffrey M, Studenski Stephanie A, Rosano Caterina, Camicioli Richard, Alexander Neil B, Chen Wen G, Lipsitz Lewis A, Carlson Michelle C
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland.
J Gerontol A Biol Sci Med Sci. 2016 Nov;71(11):1451-1458. doi: 10.1093/gerona/glw080. Epub 2016 May 6.
Research suggests that the central nervous system (CNS) and mobility are closely linked. CNS-mediated mobility impairment may represent a potentially new and prevalent syndrome within the older adult populations. Interventions targeting this group may have the potential to improve mobility and cognition and prevent disability.
In 2012, the Gerontological Society of America (GSA) and the National Institute on Aging (NIA) sponsored a 3-year conference workshop series, "Aging, the CNS, and Mobility." The goal of this third and final conference was to (i) report on the state of the science of interventions targeting CNS-mediated mobility impairment among community-dwelling older adults and (ii) partnering with the NIA, explore the future of research and intervention design focused on a potentially novel aging syndrome.
Evidence was presented in five main intervention areas: (i) pharmacology and diet; (ii) exercise; (iii) electrical stimulation; (iv) sensory stimulation/deprivation; and (v) a combined category of multimodal interventions. Workshop participants identified important gaps in knowledge and key recommendations for future interventions related to recruitment and sample selection, intervention design, and methods to measure effectiveness.
In order to develop effective preventive interventions for this prevalent syndrome, multidisciplinary teams are essential particularly because of the complex nature of the syndrome. Additionally, integrating innovative methods into the design of interventions may help researchers better measure complex mechanisms, and finally, the value of understanding the link between the CNS and mobility should be conveyed to researchers across disciplines in order to incorporate cognitive and mobility measurements into study protocols.
研究表明,中枢神经系统(CNS)与运动能力密切相关。中枢神经系统介导的运动障碍可能是老年人群中一种潜在的新的常见综合征。针对该群体的干预措施可能有改善运动能力和认知能力以及预防残疾的潜力。
2012年,美国老年学会(GSA)和美国国立衰老研究所(NIA)主办了为期三年的系列会议研讨会“衰老、中枢神经系统与运动能力”。第三次也是最后一次会议的目标是:(i)报告针对社区居住老年人中枢神经系统介导的运动障碍的干预措施的科学现状;(ii)与国立衰老研究所合作,探索专注于一种潜在的新型衰老综合征的研究和干预设计的未来方向。
在五个主要干预领域展示了相关证据:(i)药理学与饮食;(ii)运动;(iii)电刺激;(iv)感觉刺激/剥夺;以及(v)多模式干预的综合类别。研讨会参与者确定了知识方面的重要差距以及未来干预措施在招募和样本选择、干预设计以及测量有效性方法方面的关键建议。
为了针对这种常见综合征制定有效的预防性干预措施,多学科团队至关重要,尤其是考虑到该综合征的复杂性。此外,将创新方法纳入干预设计可能有助于研究人员更好地测量复杂机制,最后,应将理解中枢神经系统与运动能力之间联系的价值传达给各学科的研究人员,以便将认知和运动能力测量纳入研究方案。