Departments of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
Departments of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
J Am Med Dir Assoc. 2017 Apr 1;18(4):368.e9-368.e15. doi: 10.1016/j.jamda.2016.12.079. Epub 2017 Feb 22.
We investigated the differences in the physical function test results across stages from normal cognition (NC) to moderate Alzheimer disease (AD) and how risk factors of physical function decline are correlated with the physical function test results.
A cross-sectional study of outpatients at the Memory Disorder Outpatient Center of Japan's National Center of Geriatrics and Gerontology.
We enrolled 882 individuals aged ≥65 diagnosed with NC (n = 210), amnestic mild cognitive impairment (aMCI; n = 273), mild AD (n = 181) or moderate AD (n = 197).
We measured the participants' results for functional reach (FR), the one-leg standing (OLS) test, the Timed Up and Go (TUG) test, tandem gait (TG), and grip strength (GS). A one-way analysis of covariance (ANCOVA) was used to identify significant differences among the groups' results on the physical function tests, controlling for age, sex, educational year, Mini-Nutritional Assessment, senior activity and exercise frequency, low-density lipoprotein, body mass index, free-fat mass index, and assistance for the TUG test. Multiple regression analysis was also used to investigate the correlation between these covariates and physical function tests results.
The ANCOVA showed that FR, OLS, and TG were significantly worse among the individuals with aMCI, mild AD, or moderate AD compared with NC. However, TUG was significantly worse only in the moderate AD group compared with the NC, aMCI, and mild AD group. Multiple regression analysis showed that aging was correlated with poorer scores on all physical function tests, women had poorer scores on FR and GS than men, and low frequency of senior activity was significantly correlated with poorer scores on FR, OLS, and TG.
Postural impairment and instability on TG was seen in earlier AD stages compared with instability on TUG. As were the covariates of age and sex, senior activity frequency was significantly related to 2 or more physical function tests.
我们研究了从正常认知（NC）到中度阿尔茨海默病（AD）各个阶段的身体功能测试结果的差异，以及身体功能下降的危险因素与身体功能测试结果的相关性。
这是一项在日本国家老年医学和老年学中心记忆障碍门诊中心进行的横断面研究。
我们招募了 882 名年龄在 65 岁及以上、被诊断为 NC（n=210）、遗忘型轻度认知障碍（aMCI；n=273）、轻度 AD（n=181）或中度 AD（n=197）的患者。
我们测量了参与者的功能伸展（FR）、单腿站立（OLS）测试、计时起立行走（TUG）测试、串联步态（TG）和握力（GS）的结果。使用单向方差分析（ANCOVA）来确定这些身体功能测试结果在各组之间的显著差异，同时控制年龄、性别、受教育年限、微型营养评估、高级活动和运动频率、低密度脂蛋白、体重指数、游离脂肪质量指数以及 TUG 测试的辅助情况。我们还使用多元回归分析来研究这些协变量与身体功能测试结果之间的相关性。
ANCOVA 显示，与 NC 相比，aMCI、轻度 AD 或中度 AD 患者的 FR、OLS 和 TG 明显更差。然而，只有在中度 AD 组中，TUG 与 NC、aMCI 和轻度 AD 组相比明显更差。多元回归分析显示，所有身体功能测试的得分都与年龄增长相关，女性在 FR 和 GS 方面的得分比男性差，而高级活动频率低与 FR、OLS 和 TG 的得分差显著相关。
与 TUG 相比，在早期 AD 阶段，TG 上的姿势损害和不稳定性更明显。除了年龄和性别等协变量外，高级活动频率与 2 项或更多身体功能测试显著相关。
