Department of Family Medicine, Seoul National University Hospital, Republic of Korea.
Department of Family Medicine & Supportive Care Center, Samsung Medical Center, Seoul, Republic of Korea.
J Gerontol A Biol Sci Med Sci. 2018 Aug 10;73(9):1238-1243. doi: 10.1093/gerona/glx261.
This study evaluated whether baseline results of the Timed Up and Go (TUG) test is associated with future dementia occurrence.
Using the Korean National Health Insurance Service-National Health Screening Cohort database, we identified 49,283 subjects without a dementia diagnosis who participated in the National Screening Program for Transitional Ages at 66 years of age during 2007-2012. Gait impairment was defined as taking longer than 10 seconds to perform the TUG test. Dementia occurrence was defined by the first prescription for acetylcholinesterase inhibitors or N-Methyl-D-Aspartate receptor antagonist with an International Classification of Diseases 10th Revision (ICD-10) code for dementia (F00, F01, F02, F03, G30, F051, or G311) during 2007-2013. Cox proportional hazard regression models were used to assess the hazard ratios for dementia occurrence according to baseline TUG test results.
Mean follow-up period was 3.8 years. Incidence rates of dementia were 4.6 and 6.8 cases per 1,000 person-years in the normal and impaired TUG groups, respectively. The impaired TUG group showed a higher risk of total dementia incidence (adjusted hazard ratio [aHR], 1.34; 95% confidence interval [95% CI], 1.14-1.57). Subtype analysis showed that the impaired TUG group had a higher risk of Alzheimer's disease (aHR, 1.26; 95% CI, 1.06-1.51) and vascular dementia (aHR, 1.65; 95% CI, 1.19-2.30).
The TUG test result was associated with future dementia occurrence. More vigilant follow-up and early intervention to prevent dementia would benefit elderly people with impaired TUG test result.
本研究评估了计时起立行走（TUG）测试的基线结果是否与未来痴呆的发生有关。
利用韩国国民健康保险服务-国家健康筛查队列数据库，我们确定了 49283 名无痴呆诊断的受试者，他们在 2007-2012 年期间参加了 66 岁的国家过渡年龄段筛查计划。步态障碍定义为完成 TUG 测试的时间超过 10 秒。痴呆的发生通过 2007-2013 年期间首次开出处乙酰胆碱酯酶抑制剂或 N-甲基-D-天冬氨酸受体拮抗剂（国际疾病分类第 10 次修订版[ICD-10]痴呆代码[F00、F01、F02、F03、G30、F051 或 G311]）来定义。使用 Cox 比例风险回归模型评估基线 TUG 测试结果与痴呆发生风险的风险比。
平均随访时间为 3.8 年。正常 TUG 组和障碍 TUG 组的痴呆发生率分别为每 1000 人年 4.6 和 6.8 例。障碍 TUG 组发生总痴呆的风险较高（调整后的风险比[aHR]，1.34；95%置信区间[95%CI]，1.14-1.57）。亚组分析显示，障碍 TUG 组发生阿尔茨海默病（aHR，1.26；95%CI，1.06-1.51）和血管性痴呆（aHR，1.65；95%CI，1.19-2.30）的风险更高。
TUG 测试结果与未来痴呆的发生有关。对障碍 TUG 测试结果的老年人进行更密切的随访和早期干预以预防痴呆可能会获益。
