Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9 - section 8025, 2100, Copenhagen, Denmark.
Regional Dementia Research Centre, Department of Neurology, Zealand University Hospital, Roskilde, Denmark.
BMC Geriatr. 2020 Nov 27;20(1):513. doi: 10.1186/s12877-020-01926-9.
Several factors may play a role in the ability of patients with Alzheimer's disease to perform activities of daily living (ADL). The aim of this study was to examine the impact of different aspects of physical performance and cognitive functions on ADL in patients suffering from mild-to-moderate Alzheimer's disease.
We conducted secondary analyses on cross-sectional baseline data from the randomized controlled multicentre study "Preserving quality of life, physical health and functional ability in Alzheimer's Disease: The effect of physical exercise" (ADEX). In total, 185 AD patients (76 women and 109 men), with a mean age on 70,4 years, were included. Data from physical performance tests (Astrand cycle test, Timed up & Go (TUG), Sit to Stand test (STS)) and cognitive tests (Mini Mental Status Examination (MMSE), Symbol Digit Modalities Test (SDMT), Stroop Color and Word test (Stroop)) were used. Their associations with ADL, measured on the ADCS-ADL scale was assessed in multivariable regression analyses.
SDMT and MMSE had significant, moderate correlations with total ADL (SDMT: r = 0.33, MMSE: r = 0.42) and instrumental ADL (SDMT: r = 0.31, MMSE: r = 0.42), but not with basic ADL. Adjusting for age and sex, the associations between SDMT and MMSE to total ADL and instrumental ADL persisted. No significant associations were found between Astrand, TUG, STS or Stroop and total ADL, basic ADL or instrumental ADL.
Total ADL and instrumental ADL are associated with cognitive functions, including executive function. No significant association between examined physical performance parameters and ADL functions was observed, and consequently does not support an impact of physical function on ADL functions in patients with mild-to-moderate Alzheimer's disease and relatively well-preserved physical function. Strategies aimed to improve cognition may be better suited to improve ADL function in patients with mild-to-moderate Alzheimer's disease.
NCT01681602 . Registered 10 September 2012, retrospectively registered.
患者的多种因素可能会影响其完成日常生活活动（ADL）的能力，阿尔茨海默病患者也不例外。本研究旨在探讨不同身体机能表现和认知功能对轻中度阿尔茨海默病患者 ADL 的影响。
我们对“预防阿尔茨海默病患者生活质量、身体健康和功能能力下降：体育锻炼的效果”（ADEX）这一多中心随机对照研究的横断面基线数据进行了二次分析。共纳入 185 例 AD 患者（76 名女性，109 名男性），平均年龄为 70.4 岁。使用身体机能测试（Astrand 踏车测试、计时起立行走测试（TUG）、坐站测试（STS））和认知测试（简易精神状态检查（MMSE）、符号数字模态测试（SDMT）、斯特鲁普颜色和文字测试（Stroop））获得数据。使用多变量回归分析评估其与 ADCS-ADL 量表上 ADL 的相关性。
SDMT 和 MMSE 与 ADL 总分（SDMT：r=0.33，MMSE：r=0.42）和工具性 ADL（SDMT：r=0.31，MMSE：r=0.42）显著相关，但与基本 ADL 无关。调整年龄和性别后，SDMT 和 MMSE 与 ADL 总分和工具性 ADL 的相关性仍存在。在 Astrand、TUG、STS 或 Stroop 与 ADL 总分、基本 ADL 或工具性 ADL 之间未发现显著相关性。
ADL 总分和工具性 ADL 与认知功能有关，包括执行功能。在本研究中未观察到检查的身体机能参数与 ADL 功能之间存在显著关联，因此，不能支持身体机能对轻中度阿尔茨海默病患者 ADL 功能的影响。旨在改善认知功能的策略可能更适合改善轻中度阿尔茨海默病患者的 ADL 功能。
NCT01681602 。2012 年 9 月 10 日注册，回溯注册。
