Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Medical Department of Continuity of Care and Disability, S.Orsola-Malpighi Hospital, Bologna, Italy.
Exp Gerontol. 2018 Jul 15;108:69-76. doi: 10.1016/j.exger.2018.03.021. Epub 2018 Mar 27.
Several predictors of cognitive impairment assessed by Mini Mental State Examination (MMSE) have previously been identified. However, which predictors are the most relevant and what is their effect on MMSE categories remains unclear.
Cross-sectional and longitudinal study using data from 1116 older adults (72.6 ± 5.6 years, 579 female), 350 of whom were followed for 7 years. At baseline, the following variables were collected: personal data, marital status, occupation, anthropometric measures, risk factors, previous cardiovascular events, self-rated health and physical activity during the last week. Furthermore, routine laboratory tests, abdominal echography and a step test (with measurement of the time needed to ascend and descend two steps 20 times) were performed. The associations of these variables with cross-sectional cognitive deficit (MMSE < 24) and longitudinal cognitive decline (decrease of MMSE score over 7 years of follow-up) were investigated using logistic regression models.
Cross-sectional cognitive deficit was independently associated with school education ≤ 5 years, prolonged step test duration, having been blue collar or housewife (P ≤ 0.0001 for all) and, with lower significance, with advanced age, previous stroke and poor recent physical activity (P < 0.05). Longitudinal cognitive decline was mainly associated with step test duration (P = 0.0001) and diastolic blood pressure (P = 0.0002). The MMSE categories mostly associated with step test duration were orientation, attention, calculation and language, while memory appeared to be poorly or not affected.
In our cohort of older adults, step test duration was the most relevant predictor of cognitive impairment.
多项通过简易精神状态检查（MMSE）评估的认知障碍预测因素已被确定。然而，哪些预测因素最为相关，以及它们对 MMSE 分类的影响仍不清楚。
本研究采用来自 1116 名老年人（72.6±5.6 岁，579 名女性）的数据进行了横断面和纵向研究，其中 350 名患者接受了 7 年的随访。在基线时收集了以下变量：个人数据、婚姻状况、职业、人体测量指标、危险因素、既往心血管事件、自我报告的健康状况和过去一周的身体活动。此外，还进行了常规实验室检查、腹部超声检查和台阶测试（测量上下两个台阶 20 次所需的时间）。使用逻辑回归模型研究这些变量与横断面认知缺陷（MMSE<24）和纵向认知下降（随访 7 年 MMSE 评分下降）的关系。
横断面认知缺陷与受教育程度≤5 年、台阶测试时间延长、蓝领或家庭主妇（所有 P≤0.0001）以及年龄较大、既往卒中和近期体力活动较差（所有 P<0.05）独立相关。纵向认知下降主要与台阶测试时间相关（P=0.0001）和舒张压（P=0.0002）相关。与台阶测试时间相关性最大的 MMSE 分类是定向、注意力、计算和语言，而记忆似乎受影响较小或不受影响。
在我们的老年人群队列中，台阶测试时间是认知障碍的最相关预测因素。
