Tuena Cosimo, Mancuso Valentina, Benzi Ilaria M A, Cipresso Pietro, Chirico Alice, Goulene Karine Marie, Riva Giuseppe, Stramba-Badiale Marco, Pedroli Elisa
Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy.
Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy.
J Clin Med. 2020 Oct 23;9(11):3405. doi: 10.3390/jcm9113405.
Older people's deficits in executive functions (EF) have been shown to lead to higher fall risk, postural sway, and reduced speed. Crucially, EF impairments are even more pronounced in individuals with chronic cerebrovascular disease (CVD), namely vascular cognitive impairment.
In this retrospective cross-sectional study, we used a complete neuropsychological battery, including the Trail Making Test (TMT) and physical measures, such as the Morse fall and EQUI scales, to assess 66 individuals with chronic CVD. Linear regressions, Bayesian analyses, and model selection were performed to see the impact of EF, global cognition, and vascular parkinsonism/hemiplegia on physical measures (fall risk and balance).
The TMT part B and BA correlated ( = 0.44 and = 0.45) with Morse fall scale. Only EF significantly explained fall risk, whereas global cognition and vascular parkinsonism/hemiplegia did not. These findings were confirmed by Bayesian evidence and parsimony model selection. Balance was not significantly correlated with any of the neuropsychological tests.
This is the first study investigating the relationship between cognitive and physical measures in a sample of older people with chronic CVD. The results are consistent with previous findings that link EF with fall risk in CVD.
研究表明，老年人执行功能（EF）缺陷会导致更高的跌倒风险、姿势摇摆和速度降低。至关重要的是，在患有慢性脑血管疾病（CVD）即血管性认知障碍的个体中，EF损害更为明显。
在这项回顾性横断面研究中，我们使用了一套完整的神经心理学测试组合，包括连线测验（TMT）以及诸如莫尔斯跌倒量表和平衡量表等身体测量方法，对66名慢性CVD患者进行评估。进行线性回归、贝叶斯分析和模型选择，以观察EF、整体认知以及血管性帕金森综合征/偏瘫对身体测量指标（跌倒风险和平衡）的影响。
TMT B部分和BA与莫尔斯跌倒量表相关（分别为r = 0.44和r = 0.45）。只有EF能显著解释跌倒风险，而整体认知和血管性帕金森综合征/偏瘫则不能。这些发现得到了贝叶斯证据和简约模型选择的证实。平衡与任何神经心理学测试均无显著相关性。
这是第一项研究慢性CVD老年人群样本中认知与身体测量指标之间关系的研究。结果与之前将EF与CVD跌倒风险相关联的研究结果一致。
