Menzies Institute for Medical Research.
School of Medicine, University of Tasmania, Australia.
J Gerontol A Biol Sci Med Sci. 2018 Jan 16;73(2):255-260. doi: 10.1093/gerona/glx145.
BACKGROUND: Frailty is a prevalent geriatric condition associated with poor health outcomes. The pathogenesis of frailty is incompletely understood. We aimed to evaluate the relationship between cerebral small vessel disease (SVD) and frailty. METHODS: People aged between 60 and 85 years were randomly selected from the electoral roll into the Tasmanian Study of Cognition and Gait. Participants completed standardized questionnaires regarding medical history and underwent objective sensorimotor, gait, and cognitive testing. These data were used to calculate a frailty index score. Magnetic resonance imaging was performed on all participants to measure SVD. Automated quantification was used to measure white matter hyperintensities (WMH), with manual consensus for subcortical infarction (SI) and cerebral microbleeds (CMB). Multivariable linear regression was used to determine the association between SVD and frailty. RESULTS: The mean age of the sample (n = 388) was 72.0 years (SD 7.0), 44% (172/388) were female and the median Frailty Index was 0.20 (interquartile range 0.12, 0.27). WMH, SI, and CMB in unadjusted models were positively associated with higher frailty scores (p < .05). In final models including all brain variables, higher burden of WMH (β = 2.16; 95% confidence interval [CI] 0.75, 3.57; p = .003), but not SI (β = 2.96; 95% CI -0.44, 6.35; p = .09) or CMB (β = -0.46; 95% CI -4.88, 3.96; p = .84), was independently associated with a higher frailty score. CONCLUSIONS: We provide cross-sectional evidence for a positive association between larger burden of WMH and frailty. Longitudinal design is required to determine the temporality of this relationship.
背景:衰弱是一种普遍的老年疾病,与健康状况不佳有关。衰弱的发病机制尚未完全了解。我们旨在评估脑小血管疾病(SVD)与衰弱之间的关系。
方法:从选民名单中随机选择年龄在 60 至 85 岁之间的人参加塔斯马尼亚认知与步态研究。参与者完成了关于病史的标准化问卷,并接受了客观的感觉运动、步态和认知测试。这些数据用于计算衰弱指数评分。对所有参与者进行磁共振成像以测量 SVD。使用自动量化方法测量白质高信号(WMH),并手动确定皮质下梗死(SI)和脑微出血(CMB)。使用多变量线性回归确定 SVD 与衰弱之间的关联。
结果:样本的平均年龄(n=388)为 72.0 岁(SD=7.0),44%(172/388)为女性,衰弱指数中位数为 0.20(四分位距 0.12,0.27)。在未调整模型中,WMH、SI 和 CMB 与较高的衰弱评分呈正相关(p<0.05)。在包括所有脑部变量的最终模型中,WMH 负担较高(β=2.16;95%置信区间 [CI] 0.75,3.57;p=0.003),但 SI(β=2.96;95% CI -0.44,6.35;p=0.09)或 CMB(β=-0.46;95% CI -4.88,3.96;p=0.84)与较高的衰弱评分无关。
结论:我们提供了横断面证据,表明 WMH 负担增加与衰弱之间存在正相关。需要进行纵向设计以确定这种关系的时间顺序。
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