Oregon Research Institute, Eugene, OR 97403, USA.
Department of Exercise and Health Science, Willamette University, Salem, OR, 97301, USA.
Clin Interv Aging. 2020 Jun 22;15:945-952. doi: 10.2147/CIA.S254764. eCollection 2020.
To compare the prevalence of falls, physical performance, and dual-task cost during walking between cognitively healthy and impaired older adults at high risk of falling.
A cross-sectional analysis of 670 community-dwelling older adults who were considered at high risk of falling, operationalized as 1) having fallen at least once in the preceding 12 months and having a health-care practitioner's referral indicating that the participant was at risk of falls or 2) having impaired mobility as evidenced by a Timed Up and Go (TUG) result ≥13.5 s. Participants (mean age = 77.7 years, SD = 5.6) were divided into cognitively healthy (n = 461) or cognitively impaired (n = 209) groups using a cutoff score of <23 on the Montreal Cognitive Assessment test. Assessment included self-reported number of falls over the previous 12 months, functional reach, TUG, Short Physical Performance Battery (SPPB), and single- and dual-task walk performance. Data were analyzed using Poisson regression to estimate the prevalence ratios of falls and analysis of variance to examine between-group differences on physical performance and dual-task cost during walking performance.
In the analysis, 82.3% of older adults with cognitive impairment and 69.4% of unimpaired older adults reported 1 or more falls in the previous 12 months. Compared with cognitively healthy participants, those with cognitive impairment were 2.57 (95% confidence interval [CI] = 2.17 to 3.05) times more likely to have any fall and 2.33 (95% CI = 1.95 to 2.78) times more likely to have multiple falls. Older adults with cognitive impairment performed worse on functional reach (mean difference [MD] = -2.33 cm, 95% CI = -3.21 to -1.46), TUG (MD = 3.05 s, 95% CI = 2.22 to 3.88), and SPPB (MD = -1.24 points, 95% CI = -1.55 to -0.92) and showed increase in dual-task costs (MD = 6.59%, 95% CI = 4.19 to 9.03) compared to those without cognitive impairment.
Older adults at high risk for falls and who have cognitive impairment are associated with a greater risk for falls and decrements in physical and dual-task performance.
比较认知健康和受损的高跌倒风险老年人之间的跌倒发生率、身体表现和步行时的双重任务成本。
对 670 名社区居住的老年人进行横断面分析，这些老年人被认为有高跌倒风险，操作定义为 1）在过去 12 个月中至少跌倒一次，并且有医疗保健从业者的转介表明参与者有跌倒风险，或 2）移动能力受损，表现为计时起立行走（TUG）结果≥13.5 秒。参与者（平均年龄=77.7 岁，SD=5.6）根据蒙特利尔认知评估测试的<23 分分为认知健康组（n=461）或认知受损组（n=209）。评估包括过去 12 个月内报告的跌倒次数、功能伸展、TUG、简短体能表现测试（SPPB）以及单任务和双重任务步行表现。使用泊松回归估计跌倒的患病率比，并使用方差分析检查身体表现和步行时双重任务成本的组间差异。
在分析中，82.3%的认知障碍老年人和 69.4%的无认知障碍老年人报告在过去 12 个月内有 1 次或多次跌倒。与认知健康参与者相比，认知障碍参与者发生任何跌倒的可能性高 2.57 倍（95%置信区间[CI]为 2.17 至 3.05），发生多次跌倒的可能性高 2.33 倍（95% CI 为 1.95 至 2.78）。认知障碍老年人在功能伸展（平均差异[MD]=-2.33 厘米，95% CI=-3.21 至-1.46）、TUG（MD=3.05 秒，95% CI=2.22 至 3.88）和 SPPB（MD=-1.24 分，95% CI=-1.55 至-0.92）方面表现较差，与无认知障碍的老年人相比，双重任务成本增加（MD=6.59%，95% CI=4.19 至 9.03）。
高跌倒风险且认知受损的老年人跌倒风险增加，身体表现和双重任务表现下降。
