Department of Medicine, Division of Geriatric Medicine, Parkwood Institute, University of Western Ontario, London, ON, Canada; Gait and Brain Lab, Lawson Health Research Institute, London, ON, Canada.
School of Physical Therapy, University of Western Ontario, London, ON, Canada.
Exp Gerontol. 2018 Jul 15;108:106-111. doi: 10.1016/j.exger.2018.04.004. Epub 2018 Apr 10.
Mild cognitive impairment (MCI) and depression independently affect balance control in older adults. However, it is uncertain whether depressive symptoms would amplify balance problems in older adults with MCI.
To evaluate if the presence of significant depressive symptoms affects postural sway under somatosensory challenges in a MCI population.
Eighty two participants (mean of 75.3 ± 6.4 years of age; 46% women) with MCI completed cognitive and balance assessments. Participants were grouped by severity of depressive symptoms using the Geriatric Depression Scale-15, as MCI with depressive symptoms (MCI-D = 14, score ≥ 5) and MCI without depressive symptoms (MCI = 68, score < 5). Postural sway area was evaluated during eyes open (EO) and eyes closed (EC) while standing on a rigid flat force plate platform, and compared across groups. Analyses were controlled for age, sex, comorbidities, anti-depressant medication use, executive function, and baseline sway.
MCI-D showed larger postural sway area when compared with MCI irrespective of visual feedback conditions (p = 0.03). This difference remained significant after adjusting for anti-depressant use and executive function performance. The lack of interaction between groups and visual condition was associated with group differences in postural sway during EO condition (Beta = 0.08, CI -257.5-621.9; p = 0.41) and by comparable sway increase from EO to EC in both groups.
Depressive symptoms in individuals with MCI worsened postural stability during both eyes open and eyes closed conditions independently of cognitive function. Significant depressive symptoms may affect balance in MCI populations, potentially increasing the risk of falls.
轻度认知障碍(MCI)和抑郁会独立影响老年人的平衡控制。然而,尚不确定抑郁症状是否会放大 MCI 老年人的平衡问题。
评估在 MCI 人群中,是否存在明显的抑郁症状会影响体感挑战下的姿势摆动。
82 名 MCI 患者(平均年龄 75.3±6.4 岁,46%为女性)完成了认知和平衡评估。使用老年抑郁量表-15(Geriatric Depression Scale-15)根据抑郁症状的严重程度将参与者分组,MCI 伴抑郁症状(MCI-D=14,得分≥5)和 MCI 无抑郁症状(MCI=68,得分<5)。在睁眼(EO)和闭眼(EC)条件下,在刚性平板测力平台上站立时,评估姿势摆动面积,并在组间进行比较。分析控制了年龄、性别、合并症、抗抑郁药物使用、执行功能和基线摆动。
与 MCI 相比,MCI-D 在无论视觉反馈条件下,其姿势摆动面积都更大(p=0.03)。在调整抗抑郁药物使用和执行功能表现后,这种差异仍然显著。组间和视觉条件之间缺乏相互作用与 EO 条件下的姿势摆动组间差异相关(Beta=0.08,CI-257.5-621.9;p=0.41),并且两组的姿势摆动都从 EO 到 EC 呈现出相似的增加。
MCI 患者的抑郁症状会恶化其在睁眼和闭眼两种条件下的姿势稳定性,且独立于认知功能。明显的抑郁症状可能会影响 MCI 人群的平衡,增加跌倒的风险。