Cebrián Paula D, Cauli Omar
Department of Nursing, University of Valencia, Valencia, Spain.
Endocr Metab Immune Disord Drug Targets. 2019;19(7):1022-1031. doi: 10.2174/1871530319666190311104247.
Many neurological disorders lead to institutionalization and can be accompanied in their advanced stages by functional impairment, and progressive loss of mobility, and cognitive alterations.
We analyzed the relationship between functional impairment and cognitive performance and its related subdomains in individuals with Parkinson's disease, Alzheimer's disease accompanied by motor dysfunction, and with other neurological disorders characterized by both motor and cognitive problems.
All participants lived in nursing homes (Valencia, Spain) and underwent cognitive evaluation with the Mini-Mental State Examination; functional assessment of independence in activities of daily living using the Barthel score and Katz index; and assessment of mobility with the elderly mobility scale.
The mean age of the subjects was 82.8 ± 0.6 years, 47% of the sample included individuals with Parkinson's disease, and 48 % of the sample presented severe cognitive impairment. Direct significant relationships were found between the level of cognitive impairment and functional capacity (p < 0.01) and mobility (p < 0.05). Among the different domains, memory impairment was not associated with altered activities of daily living or mobility. The functional impairment and the risk of severe cognitive impairment were significantly (p<0.05) higher in female compared to male patients. Among comorbidities, overweight/obesity and diabetes were significantly (p < 0.05) associated with poor cognitive performance in those individuals with mild/moderate cognitive impairment.
In institutionalized individuals with movement disorders there is an association between functional and cognitive impairment. Reduction of over-weight and proper control of diabetes may represent novel targets for improving cognitive function at such early stages.
许多神经系统疾病会导致患者需要入住机构护理，在疾病晚期可能伴有功能障碍、行动能力逐渐丧失以及认知改变。
我们分析了帕金森病、伴有运动功能障碍的阿尔茨海默病以及其他以运动和认知问题为特征的神经系统疾病患者的功能障碍与认知表现及其相关子领域之间的关系。
所有参与者均居住在西班牙巴伦西亚的养老院，接受简易精神状态检查表进行认知评估；使用巴氏评分和卡茨指数对日常生活活动的独立性进行功能评估；并使用老年人活动量表评估行动能力。
受试者的平均年龄为82.8±0.6岁，样本中47%为帕金森病患者，48%的样本存在严重认知障碍。发现认知障碍程度与功能能力（p<0.01）和行动能力（p<0.05）之间存在直接显著关系。在不同领域中，记忆障碍与日常生活活动改变或行动能力无关。女性患者的功能障碍和严重认知障碍风险显著高于男性患者（p<0.05）。在合并症中，超重/肥胖和糖尿病与轻度/中度认知障碍患者的认知表现不佳显著相关（p<0.05）。
在患有运动障碍的机构护理患者中，功能障碍与认知障碍之间存在关联。减轻体重和适当控制糖尿病可能是在疾病早期改善认知功能的新靶点。
