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《英国老龄化纵向研究》中的步行速度、认知功能与痴呆风险。

Walking Speed, Cognitive Function, and Dementia Risk in the English Longitudinal Study of Ageing.

机构信息

Department of Behavioural Science and Health, University College London, London, United Kingdom.

School of Health Sciences, University of Surrey, Guildford, United Kingdom.

出版信息

J Am Geriatr Soc. 2018 Sep;66(9):1670-1675. doi: 10.1111/jgs.15312. Epub 2018 Mar 6.

Abstract

OBJECTIVES

To determine the relationships between walking speed, cognitive function, and the interaction between changes in these measures and dementia risk.

DESIGN

Longitudinal observational study.

SETTING

English Longitudinal Study of Ageing.

PARTICIPANTS

Individuals aged 60 and older (N=3,932).

MEASUREMENTS

Walking speed and cognition were assessed at Waves 1 (2002-03) and 2 (2004-05) of the English Longitudinal Study of Ageing. New dementia cases were assessed from Wave 3 (2006-07) to Wave 7 (2014-15). The associations were modelled using Cox proportional hazards regression.

RESULTS

Participants with faster baseline walking speeds were at lower risk of developing dementia (hazard ratio (HR)=0.36, 95% confidence interval (CI)=0.22-0.60). Those with a greater decline in walking speed from Wave 1 to 2 were at greater risk of developing dementia (HR=1.23, 95% CI=1.03-1.47). Participants with better baseline cognition (HR=0.42, 95% CI=0.34-0.54) were at lower risk of developing dementia. Those with a greater decline in cognition from Wave 1 to 2 were at greater risk of developing dementia (HR=1.78, 95% CI=1.53-2.06). Change in walking speed and change in cognition did not have an interactive effect on dementia risk (HR=1.01, 95% CI=0.88-1.17).

CONCLUSION

In this community-dwelling sample of English adults, those with slower walking speeds and a greater decline in speed over time were at greater risk of developing dementia independent of changes in cognition. Further research is required to understand the mechanisms that may drive these associations.

摘要

目的

确定步行速度、认知功能之间的关系,以及这些指标变化与痴呆风险之间的相互作用。

设计

纵向观察性研究。

地点

英国老龄化纵向研究。

参与者

年龄在 60 岁及以上的个体(N=3932)。

测量方法

在英国老龄化纵向研究的第 1 波(2002-03 年)和第 2 波(2004-05 年)评估步行速度和认知功能。从第 3 波(2006-07 年)到第 7 波(2014-15 年)评估新的痴呆病例。使用 Cox 比例风险回归模型来模拟关联。

结果

基线步行速度较快的参与者发生痴呆的风险较低(风险比(HR)=0.36,95%置信区间(CI)=0.22-0.60)。从第 1 波到第 2 波步行速度下降较大的参与者发生痴呆的风险较高(HR=1.23,95%CI=1.03-1.47)。基线认知功能较好的参与者(HR=0.42,95%CI=0.34-0.54)发生痴呆的风险较低。从第 1 波到第 2 波认知功能下降较大的参与者发生痴呆的风险较高(HR=1.78,95%CI=1.53-2.06)。步行速度变化和认知变化之间没有相互作用对痴呆风险的影响(HR=1.01,95%CI=0.88-1.17)。

结论

在这项英国成年人的社区居住样本中,那些行走速度较慢且随时间推移速度下降较大的人发生痴呆的风险更高,这与认知变化无关。需要进一步研究以了解可能驱动这些关联的机制。

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