Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
J Gerontol A Biol Sci Med Sci. 2021 Sep 13;76(10):e245-e252. doi: 10.1093/gerona/glaa321.
While reports of mobility problems are common with aging, their relationship to new onset of slow gait is unknown. Our objective was to examine the validity of subjective motoric complaints for predicting the incidence of slow gait.
Ambulatory community-residing participants (mean age 76.6, 55% women) with gait speeds in the normal range enrolled in an aging cohort. Five subjective motoric complaints were assessed. Incident slow gait (walking speed 1 SD below age and sex means) was the primary outcome.
Of the 548 participants at baseline, 90 had prevalent slow gait and 253 participants (73.7%) reported one or more subjective motoric complaints. Subjective motoric complaints were more common in women than men (1.78 vs 1.23). Over a median follow-up of 3.34 years, 68 participants developed new onset slow gait. All 5 questions predicted incident slow gait (adjusted hazard ratios varying from 2.26 to 4.44). More subjective motoric complaints were associated with increased risk of developing incident slow gait (hazard ratio per complaint 1.81). Predictive validity of subjective motoric complaints for incident slow gait was unchanged when using alternate outcome definitions, accounting for diagnostic misclassification, recall bias, or adjusting for multiple confounders.
Subjective motoric complaints are a harbinger of mobility disability, and can help improve clinical risk assessments and identify high-risk individuals for interventions to prevent onset of slow gait.
随着年龄的增长,行动不便的报告很常见,但它们与新出现的缓慢步态的关系尚不清楚。我们的目的是研究主观运动性抱怨对预测缓慢步态发生率的有效性。
在一个老龄化队列中,招募了有正常行走速度的社区居住的、有活动能力的参与者(平均年龄 76.6 岁,55%为女性)。评估了 5 种主观运动性抱怨。新发缓慢步态(行走速度比年龄和性别平均值低 1 个标准差)是主要结局。
在基线时的 548 名参与者中,有 90 名患有常见的缓慢步态,有 253 名参与者(73.7%)报告了一种或多种主观运动性抱怨。女性比男性更常见主观运动性抱怨(1.78 比 1.23)。在中位数为 3.34 年的随访中,有 68 名参与者新发缓慢步态。所有 5 个问题都预测了新发缓慢步态(调整后的危险比从 2.26 到 4.44 不等)。更多的主观运动性抱怨与新发缓慢步态的风险增加相关(每抱怨一个的风险比为 1.81)。当使用替代结局定义、考虑诊断错误分类、回忆偏倚或调整多个混杂因素时,主观运动性抱怨对新发缓慢步态的预测有效性不变。
主观运动性抱怨是行动不便的先兆,可以帮助改善临床风险评估,并确定需要干预以预防缓慢步态发生的高风险个体。