Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan.
Aging Clin Exp Res. 2021 Jul;33(7):1865-1873. doi: 10.1007/s40520-020-01714-w. Epub 2020 Sep 23.
It is unclear whether motor-cognitive dual tasks predict cognitive decline better than either motor or cognitive tasks alone.
To examine the utility of the novel motor-cognitive dual-task test [Stepping Trail Making Test (S-TMT)], as a predictor of cognitive decline, and compare its predictive performance with single motor or cognitive tests.
This 2-year population-based prospective study included 626 adults aged ≥ 70 years from Takashimadaira, Itabashi, Tokyo. The S-TMT measured the time taken to step on 16 numbers in order. Gait speed and TMT-A were assessed with standardized methods as single motor and cognitive tasks, respectively. A decline in the Mini-Mental State Examination score by ≥ 3 points over 2 years was defined as a significant cognitive decline.
Over 2 years, 97 (15.5%) experienced cognitive decline. After adjusting for confounders, binary logistic regression models showed no significant associations between gait speed, TMT-A time tertiles, and risk of cognitive decline, but participants in the longest tertile of S-TMT time were more likely to develop cognitive decline than those of the shortest tertile (odds ratio 2.14; 95% confidence interval 1.17-3.90). Only the addition of the S-TMT time to the covariates model significantly improved the reclassification indices for predicting cognitive decline (net reclassification improvement: 0.31, P < 0.01; integrated discrimination improvement: 0.01, P = 0.02).
Only the S-TMT was significantly associated with cognitive decline and improved reclassification indices, indicating that it is more useful for predicting cognitive decline than individual gait speed or visual tracking tests alone.
目前尚不清楚运动认知双重任务是否比单一的运动或认知任务更能预测认知能力下降。
研究新型运动认知双重任务测试（Stepping Trail Making Test，S-TMT）作为认知能力下降预测指标的效用，并将其预测性能与单一运动或认知测试进行比较。
这是一项为期 2 年的基于人群的前瞻性研究，共纳入了来自东京板桥区高岛平的 626 名年龄≥70 岁的成年人。S-TMT 测试要求以顺序的方式踏 16 个数字。采用标准化方法评估步态速度和 TMT-A，分别作为单一的运动和认知任务。在 2 年内 Mini-Mental State Examination 评分下降≥3 分定义为显著认知能力下降。
在 2 年内，97 人（15.5%）经历了认知能力下降。调整混杂因素后，二元逻辑回归模型显示，步态速度、TMT-A 时间三分位数与认知能力下降风险之间无显著关联，但 S-TMT 时间最长三分位的参与者发生认知能力下降的风险高于最短三分位的参与者（比值比 2.14；95%置信区间 1.17-3.90）。仅将 S-TMT 时间添加到协变量模型中，才能显著提高预测认知能力下降的重新分类指数（净重新分类改善：0.31，P<0.01；综合判别改善：0.01，P=0.02）。
只有 S-TMT 与认知能力下降显著相关，并改善了重新分类指数，这表明它比单一的步态速度或视觉追踪测试更能预测认知能力下降。
