脑淀粉样蛋白与皮质下缺血性血管性认知障碍患者认知功能变化及跌倒风险之间的关联。
Associations between cerebral amyloid and changes in cognitive function and falls risk in subcortical ischemic vascular cognitive impairment.
作者信息
Dao Elizabeth, Best John R, Hsiung Ging-Yuek Robin, Sossi Vesna, Jacova Claudia, Tam Roger, Liu-Ambrose Teresa
机构信息
Department of Physical Therapy, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6S 0A9, Canada.
出版信息
BMC Geriatr. 2017 Jun 28;17(1):133. doi: 10.1186/s12877-017-0522-4.
BACKGROUND
To determine the association between amyloid-beta (Aβ) plaque deposition and changes in global cognition, executive functions, information processing speed, and falls risk over a 12-month period in older adults with a primary clinical diagnosis of subcortical ischemic vascular cognitive impairment (SIVCI).
METHODS
This is a secondary analysis of data acquired from a subset of participants (N = 22) who were enrolled in a randomized controlled trial of aerobic exercise (NCT01027858). The subset of individuals completed an C Pittsburgh compound B (PIB) scan. Cognitive function and falls risk were assessed at baseline, 6-months, and 12-months. Global cognition, executive functions, and information processing speed were measured using: 1) ADAS-Cog; 2) Trail Making Test; 3) Digit Span Test; 4) Stroop Test, and 5) Digit Symbol Substitution Test. Falls risk was measured using the Physiological Profile Assessment. Hierarchical multiple linear regression analyses determined the unique contribution of Aβ on changes in cognitive function and falls risk at 12-months after controlling for experimental group (i.e. aerobic exercise training or usual care control) and baseline performance. To correct for multiple comparisons, we applied the Benjamini-Hochberg procedure to obtain a false discovery rate corrected threshold using alpha = 0.05.
RESULTS
Higher PIB retention was significantly associated with greater decrements in set shifting (Trail Making Test, adjusted R = 35.3%, p = 0.002), attention and conflict resolution (Stroop Test, adjusted R = 33.4%, p = 0.01), and information processing speed (Digit Symbol Substitution Test, adjusted R = 24.4%, p = 0.001) over a 12-month period. Additionally, higher PIB retention was significantly associated with increased falls risk (Physiological Profile Assessment, adjusted R = 49.1%, p = 0.04). PIB retention was not significantly associated with change in ADAS-Cog and Verbal Digit Span Test (p > 0.05).
CONCLUSIONS
Symptoms associated with SIVCI may be amplified by secondary Aβ pathology.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT01027858 , December 7, 2009.
背景
确定在初步临床诊断为皮质下缺血性血管性认知障碍（SIVCI）的老年人中，β淀粉样蛋白（Aβ）斑块沉积与12个月内整体认知、执行功能、信息处理速度和跌倒风险变化之间的关联。
方法
这是对从参与有氧运动随机对照试验（NCT01027858）的一部分参与者（N = 22）获取的数据进行的二次分析。这些个体完成了匹兹堡化合物B（PIB）扫描。在基线、6个月和12个月时评估认知功能和跌倒风险。使用以下方法测量整体认知、执行功能和信息处理速度：1）阿尔茨海默病协作研究认知量表（ADAS-Cog）；2）连线测验；3）数字广度测验；4）斯特鲁普测验；5）数字符号替换测验。使用生理特征评估来测量跌倒风险。分层多元线性回归分析确定了在控制实验组（即有氧运动训练或常规护理对照）和基线表现后，Aβ对12个月时认知功能变化和跌倒风险的独特贡献。为了校正多重比较，我们应用了Benjamini-Hochberg程序，使用α = 0.05获得错误发现率校正阈值。
结果
较高的PIB保留率与12个月内转换能力（连线测验，调整后R = 35.3%，p = 0.002）、注意力和冲突解决能力（斯特鲁普测验，调整后R = 33.4%，p = 0.01）以及信息处理速度（数字符号替换测验，调整后R = 24.4%，p = 0.001）的更大下降显著相关。此外，较高的PIB保留率与跌倒风险增加显著相关（生理特征评估，调整后R = 49.1%，p = 0.04）。PIB保留率与ADAS-Cog和言语数字广度测验的变化无显著关联（p > 0.05）。
结论
与SIVCI相关的症状可能会因继发性Aβ病理而加剧。
试验注册
ClinicalTrials.gov，NCT01027858，2009年12月7日。
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