Neuroscience Research Australia, UNSW Sydney, Randwick, NSW, Australia.
Prince of Wales Clinical School, Faculty of Medicine, UNSW Sydney, Randwick, Australia.
J Alzheimers Dis. 2021;81(2):833-841. doi: 10.3233/JAD-201325.
In older people with cognitive impairment (CI), executive function (EF) has been associated with motor performance including balance and gait. The literature examining and supporting a relationship between balance performance and other cognitive domains is limited.
To investigate the relationship between global cognition and cognitive domain function and balance performance in older people with CI.
The iFOCIS randomized controlled trial recruited 309 community-dwelling older people with CI. Baseline assessments completed before randomization were used for analyses including the Addenbrooke's Cognitive Examination-III (ACE-III; global cognition) and its individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) and the Frontal Assessment Battery (FAB), a measure of EF. A composite balance score was derived from postural sway and leaning balance tests.
In linear regression analyses adjusted for covariates, global cognition and each cognitive domain were significantly associated with balance performance. EF (verbal fluency; β= -0.254, p < 0.001, adjusted R2 = 0.387) and visuospatial ability (β= -0.258, p < 0.001, adjusted R2 = 0.391) had the strongest associations with balance performance. In a comprehensively adjusted multivariable model including all of the ACE-III cognitive domains, visuospatial ability and EF (verbal fluency) were independently and significantly associated with balance performance.
Poorer global cognition and cognitive domain function were associated with poorer balance performance in this sample of people with CI. Visuospatial ability and EF were independently associated with balance, highlighting potential shared neural networks and the role higher-level cognitive processes and spatial perception/processing play in postural control.
在认知障碍（CI）的老年人中，执行功能（EF）与运动表现（包括平衡和步态）有关。检查和支持平衡表现与其他认知领域之间关系的文献有限。
调查认知障碍老年人的整体认知和认知领域功能与平衡表现之间的关系。
iFOCIS 随机对照试验招募了 309 名居住在社区的认知障碍老年人。在随机分组前完成的基线评估用于分析，包括 Addenbrooke 认知测验-III（ACE-III；整体认知）及其各个认知领域（注意力；记忆；语言流畅性；语言；视空间能力）和额叶评估量表（FAB），这是 EF 的一种衡量方法。从姿势摆动和倾斜平衡测试中得出综合平衡评分。
在调整协变量的线性回归分析中，整体认知和每个认知领域都与平衡表现显著相关。EF（语言流畅性；β= -0.254，p < 0.001，调整后的 R2= 0.387）和视空间能力（β= -0.258，p < 0.001，调整后的 R2= 0.391）与平衡表现的关联最强。在一个包括 ACE-III 所有认知领域的综合调整多变量模型中，视空间能力和 EF（语言流畅性）与平衡表现独立且显著相关。
在本认知障碍患者样本中，整体认知和认知领域功能较差与平衡表现较差相关。视空间能力和 EF 与平衡独立相关，突出了潜在的共享神经网络以及更高层次的认知过程和空间感知/处理在姿势控制中的作用。
