老年人多发性硬化症的身体和认知功能、身体活动和久坐行为。
Physical and Cognitive Functions, Physical Activity, and Sedentary Behavior in Older Adults With Multiple Sclerosis.
机构信息
Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana.
Department of Physical Therapy, The University of Alabama at Birmingham.
出版信息
J Geriatr Phys Ther. 2019 Oct/Dec;42(4):304-312. doi: 10.1519/JPT.0000000000000163.
BACKGROUND AND PURPOSE
Older adults with multiple sclerosis (MS) experience age-related declines in physical and cognitive functions that may be compounded by the disease and its progression and worsened by physical inactivity and sedentary behavior. However, the extent to which impairments in physical and cognitive functions are manifestations of MS and disease progression, reflective of the general aging process, or perhaps 2 detrimental processes exacerbating the synergistic effects of the other is relatively unknown. This study compared physical and cognitive functions, sedentary behavior, and physical activity between 40 older adults with MS (ie, 60 years of age and older) and 40 age- and sex-matched healthy older adults. We further examined whether physical activity and/or sedentary behavior explained differences between groups in physical and cognitive functions.
METHODS
Participants initially underwent the cognitive assessments, followed by the physical function assessments. The order of tests was standardized and participants were provided seated-rest between the administrations of the physical function assessments. Participants were then instructed to wear an accelerometer and document wear time in a log book for a 7-day period after the testing session.
RESULTS
Multivariate analyses of variance indicated that older adults with MS (n = 40) performed worse on all measures of physical function, and 1 measure of cognitive function (ie, information-processing speed), compared with healthy controls (n = 40). Older adults with MS engaged in less moderate-to-vigorous physical activity, more sedentary behavior, and longer duration of long sedentary bouts than healthy controls. Pearson correlations demonstrated that levels and patterns of physical activity were significantly associated with a majority of physical function variables but not cognitive function variables in both older adults with MS and healthy controls but to a greater extent in older adults with MS. Partial Pearson correlations further demonstrated that levels and patterns of sedentary behavior were significantly associated with a majority of physical function variables but not cognitive function variables primarily in older adults with MS. Linear regression analyses indicated that levels and patterns of physical activity and sedentary behavior partially accounted for differences in physical and cognitive function variables between older adults with MS and healthy controls.
CONCLUSION
There is evidence of reduced function in older adults with MS, and this might be partially managed by behavioral interventions that target physical activity and sedentary behavior for the promotion of healthy aging in older adults with MS.
背景与目的
多发性硬化症(MS)老年患者会出现与年龄相关的身体和认知功能下降,而疾病及其进展可能会使这些下降更加严重,身体活动不足和久坐行为也会使这些下降更加严重。然而,身体和认知功能的损害在多大程度上是 MS 和疾病进展的表现,反映了一般的衰老过程,或者可能是两种有害的过程加剧了彼此的协同效应,目前还相对未知。本研究比较了 40 名多发性硬化症老年患者(即 60 岁及以上)和 40 名年龄和性别匹配的健康老年患者的身体和认知功能、久坐行为和身体活动。我们还进一步研究了身体活动和/或久坐行为是否解释了组间身体和认知功能的差异。
方法
参与者首先接受认知评估,然后接受身体功能评估。测试的顺序是标准化的,参与者在身体功能评估之间被安排了坐位休息。然后,参与者被要求佩戴加速度计,并在测试后 7 天内的日志中记录佩戴时间。
结果
多元方差分析表明,与健康对照组(n=40)相比,多发性硬化症老年患者(n=40)在所有身体功能测量指标上表现更差,在 1 项认知功能测量指标(即信息处理速度)上表现更差。多发性硬化症老年患者的中高强度身体活动较少,久坐行为较多,长时间久坐的时间较长。Pearson 相关分析表明,在多发性硬化症老年患者和健康对照组中,身体活动的水平和模式与大多数身体功能变量显著相关,但与认知功能变量相关性不大,但在多发性硬化症老年患者中相关性更大。偏 Pearson 相关分析进一步表明,在多发性硬化症老年患者中,身体活动和久坐行为的水平和模式与大多数身体功能变量显著相关,但与认知功能变量相关性不大。线性回归分析表明,身体活动和久坐行为的水平和模式部分解释了多发性硬化症老年患者和健康对照组身体和认知功能变量的差异。
结论
多发性硬化症老年患者的功能确实有所下降,这可能可以通过针对身体活动和久坐行为的行为干预来部分管理,以促进多发性硬化症老年患者的健康老龄化。