意大利南部老年人群中运动认知风险综合征的身体和认知特征。
Physical and cognitive profiles in motoric cognitive risk syndrome in an older population from Southern Italy.
机构信息
Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study,", National Institute of Gastroenterology "Saverio de Bellis," Research Hospital, Castellana Grotte, Italy.
Global Brain Health Institute, University of California, San Francisco, CA, USA.
出版信息
Eur J Neurol. 2021 Aug;28(8):2565-2573. doi: 10.1111/ene.14882. Epub 2021 May 14.
BACKGROUND AND PURPOSE
In older age, physical and cognitive declines have been shown to occur simultaneously or consequent to one another, and several operational definitions have been proposed to consider the co-presence of the two declines; for example, "Motoric cognitive risk syndrome" (MCR) has been proposed as a definition for the coexistence of slow gait plus subjective cognitive complaints. Given the increasing interest in MCR and its potential role as both biomarker and therapeutic target, we aimed to estimate its prevalence in a large cohort of non-demented older subjects, and to examine the associations between physical status, global cognitive dysfunction, and impairment in various cognitive domains in MCR.
METHODS
A population-based sample of 1041 older people in Southern Italy (mean age 75.15 years) was enrolled. We defined MCR using slowness and a single question for subjective cognitive complaints. We also administered a comprehensive neuropsychological test battery, together with tests assessing physical function.
RESULTS
The prevalence of MCR was 9.9% (95% confidence interval 8.2-11.9). MCR was associated with decreased processing speed and executive function after adjusting for all relevant confounders. However, we found no significant association of MCR with decreased global cognition and immediate/delayed free recall of verbal memory. MCR was also associated with increased exhaustion, low muscle strength, and low physical activity, and increased levels of C-reactive protein and interleukin-6.
CONCLUSIONS
The present findings on MCR prevalence and associated cognitive and physical domains and inflammatory biomarkers may help to uncover altered pathways and therapeutic targets for intervention during the long preclinical phase of neurodegenerative dementia.
背景与目的
在老年人群中,身体和认知功能的衰退同时或相继发生,已有几种操作定义被提出用于考虑这两种衰退的共同存在;例如,“运动认知风险综合征”(MCR)被提议作为慢步速加上主观认知抱怨共存的定义。鉴于对 MCR 的日益关注及其作为生物标志物和治疗靶点的潜在作用,我们旨在估计其在大量非痴呆老年受试者中的患病率,并检查 MCR 中身体状况、整体认知功能障碍以及各种认知领域受损之间的关联。
方法
我们招募了意大利南部一个基于人群的 1041 名老年人样本(平均年龄 75.15 岁)。我们使用缓慢和一个关于主观认知抱怨的问题来定义 MCR。我们还进行了全面的神经心理学测试组合,以及评估身体功能的测试。
结果
MCR 的患病率为 9.9%(95%置信区间 8.2-11.9)。在调整所有相关混杂因素后,MCR 与处理速度和执行功能下降相关。然而,我们没有发现 MCR 与整体认知下降以及言语记忆的即时/延迟自由回忆显著相关。MCR 还与疲劳增加、肌肉力量减弱和身体活动减少以及 C 反应蛋白和白细胞介素-6 水平升高相关。
结论
关于 MCR 患病率以及相关认知和身体领域和炎症生物标志物的本研究结果可能有助于揭示在神经退行性痴呆的漫长临床前阶段改变的途径和治疗靶点,以进行干预。