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老年人精细运动技能和认知障碍的困难:Progetto Veneto Anziani。

Difficulties with Fine Motor Skills and Cognitive Impairment in an Elderly Population: The Progetto Veneto Anziani.

机构信息

Department of Medicine, Geriatrics Division, University of Padova, Padova, Italy.

National Research Council, Neuroscience Institute, Padova, Italy.

出版信息

J Am Geriatr Soc. 2018 Feb;66(2):350-356. doi: 10.1111/jgs.15209. Epub 2018 Jan 11.

Abstract

OBJECTIVES

To investigate dysfunction in fine motor skills in a cohort of older Italian adults, identifying their prevalence and usefulness as indicators and predictors of cognitive impairment.

DESIGN

Population-based longitudinal study with mean follow-up of 4.4 years.

SETTING

Community.

PARTICIPANTS

Older men and women enrolled in the Progetto Veneto Anziani (Pro.V.A.) (N = 2,361); 1,243 subjects who were cognitively intact at baseline were selected for longitudinal analyses.

MEASUREMENTS

Fine motor skills were assessed by measuring the time needed to successfully complete two functional tasks: putting on a shirt and a manual dexterity task. Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score less than 24.

RESULTS

On simple correlation, baseline MMSE score was significantly associated with the manual dexterity task (correlation coefficient (r) = -0.25, P < .001) and time needed to put on a shirt (r = -0.29, P < .001). Over the study period, changes in time needed to perform the fine motor tasks were significantly associated with changes in MMSE (putting on a shirt: β = 0.083, P = .003; manual dexterity task: β = 0.098, P < .001). Logistic regression analyses confirmed that worse results on tasks were associated with cognitive impairment at baseline (odds ratio (OR) = 2.47, 95% confidence interval (CI) = 1.74-3.50, for the fourth quartile of time needed to put on a shirt; OR = 1.98, 95% CI = 1.42-2.76, for the fourth manual dexterity task quartile) and greater risk of cognitive impairment developing during follow-up (OR = 4.38, 95% CI = 2.46-7.80, for the fourth quartile of time needed to put on a shirt; OR = 2.20, 95% CI = 1.30-3.72, for the fourth manual dexterity task quartile).

CONCLUSIONS

Difficulties with fine motor skills are common in older adults, and assessing them may help to identify early signs of dementia, subjects at high risk to develop cognitive decline, and individuals who can be referred to specialists.

摘要

目的

研究意大利老年人群中精细运动技能障碍的发生率,确定其作为认知障碍的指标和预测因素的有用性。

设计

具有平均 4.4 年随访的基于人群的纵向研究。

地点

社区。

参与者

参加 Progetto Veneto Anziani(Pro.V.A.)的老年男女(N=2361);选择了基线时认知正常的 1243 名受试者进行纵向分析。

测量方法

通过测量成功完成两项功能性任务所需的时间来评估精细运动技能:穿衬衫和手动灵巧性任务。认知障碍定义为简易精神状态检查(MMSE)得分<24。

结果

简单相关分析显示,基线 MMSE 评分与手动灵巧性任务(相关系数(r)=-0.25,P<.001)和穿衬衫所需时间(r=-0.29,P<.001)显著相关。在研究期间,执行精细运动任务所需时间的变化与 MMSE 的变化显著相关(穿衬衫:β=0.083,P=0.003;手动灵巧任务:β=0.098,P<.001)。逻辑回归分析证实,任务表现越差,与基线时的认知障碍相关(第 4 个穿衬衫时间四分位组的比值比(OR)=2.47,95%置信区间(CI)=1.74-3.50;第 4 个手动灵巧任务四分位组的 OR=1.98,95%CI=1.42-2.76),并且在随访期间发生认知障碍的风险更高(第 4 个穿衬衫时间四分位组的 OR=4.38,95%CI=2.46-7.80;第 4 个手动灵巧任务四分位组的 OR=2.20,95%CI=1.30-3.72)。

结论

精细运动技能障碍在老年人中很常见,评估这些技能可能有助于识别痴呆的早期迹象、认知能力下降风险高的受试者以及需要转介给专家的个体。

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