Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-90187, Umeå, Sweden.
Department of Nursing, Umeå University, SE-90187, Umeå, Sweden.
BMC Geriatr. 2020 Jan 31;20(1):34. doi: 10.1186/s12877-020-1433-3.
Cognition has been related with gait speed in older adults; however, studies involving the oldest age group, where many have mobility disability and cognitive impairment, are few. The aim was to investigate the association between global cognitive function and gait speed in a representative sample of very old people, and whether the association was affected by dementia, and walking aid use.
This cross-sectional study included 1317 participants, mean age 89.4 years, and 68% women, from the Umeå85+/Gerontological Regional Database. Self-paced gait speed was measured over 2.4 m, with or without walking aids, and global cognitive function with the Mini-Mental State Examination (MMSE). The association between cognition and gait speed was analyzed using multiple linear regression and stratified according to dementia. The influence of missing gait speed values was explored using multiple imputation. An interaction analysis was performed to investigate the influence of walking aid use.
In comprehensively adjusted analyses, MMSE associated with gait speed (unstandardized β (β) 0.011 m/s, 95% Confidence Interval [CI] = 0.009, 0.013, p < 0.001) in the total sample. No association was found in people with dementia (β 0.003 m/s, 95%CI = 0.000, 0.006, p = 0.058), until missing gait speed values were compensated for by multiple imputation (β 0.007 m/s, 95% [CI] = 0.002, 0.011, p = 0.002). In interaction analysis the use of walking aids attenuated the association between cognition and gait speed (β - 0.019 m/s, 95%CI = - 0.024, - 0.013, p < 0.001).
Global cognitive function appears to associate with gait speed in very old people. However, in people with dementia selection bias was indicated since unless missing gait speed values were accounted for no association was observed. Walking aid use attenuated cognitive load, which may not apply to walking in daily activities, and requires further investigation.
认知能力与老年人的步态速度有关；然而，涉及到年龄最大的群体（许多人有行动障碍和认知障碍）的研究很少。本研究旨在调查一个具有代表性的非常老年人样本中整体认知功能与步态速度之间的关联，以及这种关联是否受到痴呆症和助行器使用的影响。
本横断面研究纳入了来自于于默奥 85+ /老年区域数据库的 1317 名参与者，平均年龄为 89.4 岁，其中 68%为女性。自行调整步态速度测量距离为 2.4 米，无论是否使用助行器，整体认知功能采用简易精神状态检查（MMSE）进行评估。使用多元线性回归分析认知与步态速度之间的关系，并根据痴呆症进行分层分析。使用多重插补法探讨缺失步态速度值的影响。进行交互分析以研究助行器使用的影响。
在综合调整分析中，MMSE 与步态速度相关（未标准化β（β）0.011m/s，95%置信区间[CI] 0.009，0.013，p<0.001）。在痴呆症患者中未发现相关性（β 0.003m/s，95%CI 0.000，0.006，p=0.058），直到通过多重插补补偿缺失的步态速度值后才发现相关性（β 0.007m/s，95%CI 0.002，0.011，p=0.002）。在交互分析中，助行器的使用减弱了认知与步态速度之间的关联（β-0.019m/s，95%CI-0.024，-0.013，p<0.001）。
整体认知功能似乎与非常老年人的步态速度相关。然而，在痴呆症患者中，由于除非考虑缺失的步态速度值，否则未观察到相关性，表明存在选择偏倚。助行器的使用减轻了认知负担，但这可能不适用于日常生活中的行走，需要进一步研究。
