From the Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts (HKS, JFB); Spaulding Rehabilitation Hospital, Charlestown, Massachusetts (HKS, JFB); Massachusetts Veterans Epidemiology Research and Information Center, Geriatric Research Education and Clinical Center, Boston, Massachusetts (LQ, JFB); Psychology Service, VA Boston Healthcare System, Boston, Massachusetts (LG); and Department of Psychiatry, School of Medicine, Boston University, Boston, Massachusetts (LG).
Am J Phys Med Rehabil. 2019 Aug;98(8):685-691. doi: 10.1097/PHM.0000000000001175.
We investigated the associations between mild cognitive impairment (MCI), social engagement (SE), and mobility.
We evaluated data from a cohort study of older adult primary care patients (N = 430). Outcomes included self-reported function (Late-Life Function Instrument [LLFI]) and performance-based mobility (Short Physical Performance Battery score [SPPB]). Linear regression models evaluated the association between MCI and mobility, MCI and SE, mobility measures and SE, and whether SE mediated the association between MCI status and mobility.
Participants with MCI had significantly lower mobility and lower SE as compared with those without MCI (LLFI: 53.5 vs. 56.9, P < 0.001; SPPB: 7.9 vs. 9.3, P < 0.001; SE score: 44.9 vs. 49.0, P < 0.001). Mild cognitive impairment was significantly associated with both LLFI and SPPB (LLFI β = -2.93, P < 0.001; SPPB β = -1.26, P < 0.001) and SE (β = -3.20, P < 0.001). Social engagement was significantly associated with both LLFI and SPPB (LLFI β = 0.22; P < 0.001; SPPB β = 0.08; P < 0.001). There was a positive association between SE and mobility (P< 0.05). A mediator effect of SE was supported when evaluating the association between MCI and mobility.
Among older adult primary care patients at risk for mobility decline, higher levels of SE mitigate the association between MCI and mobility.
我们研究了轻度认知障碍（MCI）、社会参与（SE）和移动能力之间的关联。
我们评估了一项老年初级保健患者队列研究的数据（N=430）。结果包括自我报告的功能（晚年功能仪器[LLFI]）和基于表现的移动能力（简短身体表现电池评分[SPPB]）。线性回归模型评估了 MCI 与移动能力、MCI 与 SE、移动能力测量值与 SE 之间的关联，以及 SE 是否介导了 MCI 状态与移动能力之间的关联。
与无 MCI 者相比，MCI 患者的移动能力和 SE 显著较低（LLFI：53.5 与 56.9，P<0.001；SPPB：7.9 与 9.3，P<0.001；SE 评分：44.9 与 49.0，P<0.001）。MCI 与 LLFI 和 SPPB 显著相关（LLFIβ=-2.93，P<0.001；SPPBβ=-1.26，P<0.001）和 SE（β=-3.20，P<0.001）。SE 与 LLFI 和 SPPB 显著相关（LLFIβ=0.22；P<0.001；SPPBβ=0.08；P<0.001）。SE 与移动能力呈正相关（P<0.05）。在评估 MCI 与移动能力之间的关联时，SE 的中介效应得到支持。
在有移动能力下降风险的老年初级保健患者中，较高的 SE 水平减轻了 MCI 与移动能力之间的关联。
