Fujita Kazuki, Jinnouchi Hiroshige, Fujii Atsuko
Center for Education in Liberal Arts and Sciences, Osaka University.
Department of Hygiene and Public Health, Nippon Medical School.
Nihon Koshu Eisei Zasshi. 2021 Jan 30;68(1):23-32. doi: 10.11236/jph.20-043. Epub 2020 Dec 19.
Objectives Cognitive function is an important component of health and quality of life in older adults. Locomotive syndrome (LS) is associated with cognitive decline, but this has not been sufficiently shown. Therefore, the purpose of this study was to determine the association between LS and cognitive decline in community-dwelling older adults.Methods Study participants were 3,751 community-dwelling elderly people (1,914 men and 1,837 women; mean age 71.9±5.7 years) who completed the 25-question Geriatric Locomotive Function Scale (GLFS-25) and the Kihon Checklist administered by the local government in Japan between 2014 and 2016. LS stage was assessed using the total score from the GLFS-25 (non-LS: a score of ≤6, Stage 1: a score of ≥7, and Stage 2: a score of ≥16). The risk of cognitive decline was assessed by the applicable number of 3 cognitive-related items on the Kihon Checklist (mild decline: applicable number ≥1, moderate decline: applicable number ≥2). Multinomial logistic regression analysis adjusted for age, BMI, nutritional status, oral function, and homebound status was used to calculate the odds ratios (ORs) of the LS stage for the risk of cognitive decline.Results In the multinomial logistic regression model, participants in both stages 1 and 2 of LS had significantly higher ORs for mild cognitive decline than those without LS in men and women. Similar results were observed with moderate cognitive decline. The ORs of LS stages for moderate cognitive decline were as follows: in the multinomial logistic regression model, OR was 1.65 (95% CI, 0.97-2.81) in stage 1 of LS and 2.99 (95% CI, 1.56-5.73) in stage 2 of LS in men (P<0.001), and OR was 1.97 (95%CI, 1.11-3.50) in LS stage 1 and 2.43 (95% CI, 1.14-5.19) in stage 2 of LS in women (P<0.01).Conclusion This study showed that LS stage had a significant positive association with the decline in cognitive function in older adults and it was more remarkable in cases of increased cognitive decline. Our results suggest that LS might be an independent factor of cognitive decline in community-dwelling elderly people. A longitudinal survey is needed to clarify the association between LS and cognitive function.
目的 认知功能是老年人健康和生活质量的重要组成部分。运动机能综合征（LS）与认知功能下降有关，但这一点尚未得到充分证实。因此，本研究旨在确定社区居住老年人中LS与认知功能下降之间的关联。
方法 研究参与者为3751名社区居住的老年人（1914名男性和1837名女性；平均年龄71.9±5.7岁），他们在2014年至2016年间完成了由日本地方政府实施的25题老年运动机能功能量表（GLFS-25）和简易检查表。使用GLFS-25的总分评估LS阶段（非LS：得分≤6，第1阶段：得分≥7，第2阶段：得分≥16）。通过简易检查表上3项认知相关项目的适用数量评估认知功能下降的风险（轻度下降：适用数量≥1，中度下降：适用数量≥2）。采用多因素logistic回归分析，对年龄、体重指数、营养状况、口腔功能和居家状态进行调整，以计算LS阶段与认知功能下降风险的比值比（OR）。
结果 在多因素logistic回归模型中，LS第1阶段和第2阶段的参与者出现轻度认知功能下降的OR均显著高于无LS的参与者，男性和女性均如此。中度认知功能下降时也观察到类似结果。LS各阶段中度认知功能下降的OR如下：在多因素logistic回归模型中，男性LS第1阶段的OR为1.65（95%CI，0.97-2.81），第2阶段为2.99（95%CI，1.56-5.73）（P<0.001）；女性LS第1阶段的OR为1.97（95%CI，1.11-
