机构养老的老年人中，受轻度认知障碍影响和未受影响者的功能能力及双任务成本。
Functional capacity and dual-task cost in the institutionalized older adults, both affected and unaffected by mild cognitive impairment.
作者信息
Zak Marek, Krupnik Szymon, Brola Waldemar, Rebak Dorota, Sikorski Tomasz, Dutheil Frederic, Andrychowski Jaroslaw, Courteix Daniel
机构信息
The Institute of Health Sciences, Collegium Medicum, The Jan Kochanowski University, ul. Zeromskiego 5, 25-369, Kielce, Poland.
Symmetry, Medical Rehabilitation Centre, Sosnowiec, Poland.
出版信息
Eur Rev Aging Phys Act. 2021 Jul 12;18(1):16. doi: 10.1186/s11556-021-00270-0.
BACKGROUND
Mild cognitive impairment (MCI) affects 10-20% of the individuals over the age of 65; this proportion being higher in the institutional care facilities than within a general population.
AIM
To assess whether dual-task cost in the individuals affected by MCI depends exclusively on gait, or possibly some other functional capacity components might also come into play, as compared to the healthy controls also remaining in the institutional care.
METHODS
The study was conducted in five nursing facilities, involving 88 subjects in total, i.e. 44 subjects affected by MCI (mean age of 83.8 years; 34 women (77.3%) and 10 men (22.7%), and 44 healthy controls (mean age 81.67 years; 38 women (84.4%) and 7 men (15.6%). Cognitive functions were assessed through Mini-Mental State Examination (MMSE), while gait by Timed Up and Go Test (TUGT). Gait speed was calculated by the 10 Meter Walk Test, and the fear of falling with the Falls Efficacy Scale International. Dual tasks were assessed by TUGT (Timed Up and Go Test Manual) and TUG (Timed Up and Go Test Cognitive). Dual Task Cost (DTC) of TUGT and TUGT was established. Statistical analyses were completed with STATISTICA Package v. 10.
RESULTS
Individuals affected by MCI differed significantly from the unaffected ones with regard to their gait test results, when assigned a single-task activity, and dual-task activities, as well as in the gait speed. Dual Task Cost Manual (DTC) in the MCI group was significantly higher, as compared to the subjects unaffected by MCI. Around 25% of the variance of DTC result regarding the MCI group was accounted for by gait performance in the single-task conditions (TUGT). In the case of Dual Task Cost Cognitive (DTC), this value equalled to approx. 10%. A 1% change in DTC corresponded to approx. 0.5 s change in TUGT, whereas a 1% change in DTC entailed approx. 0.35 s change in TUGT walking time.
CONCLUSION
Individual functional capacity affected the dual-task performance, especially the motor-motor tasks. Dual-task cost in the subjects affected by MCI was significantly reduced, being more dependent on the gait speed in the motor-motor tasks, which entailed visual memory, than in the motor-cognitive tasks.
背景
轻度认知障碍（MCI）影响着10%至20%的65岁以上人群；这一比例在机构护理设施中高于普通人群。
目的
评估与同样住在机构护理机构的健康对照组相比，受MCI影响的个体的双重任务成本是否仅取决于步态，或者其他一些功能能力成分是否也可能起作用。
方法
该研究在五个护理机构进行，共涉及88名受试者，即44名受MCI影响的受试者（平均年龄83.8岁；34名女性（77.3%）和10名男性（22.7%）），以及44名健康对照组（平均年龄81.67岁；38名女性（84.4%）和7名男性（15.6%））。通过简易精神状态检查表（MMSE）评估认知功能，通过定时起立行走测试（TUGT）评估步态。通过10米步行测试计算步速，通过国际跌倒效能量表评估跌倒恐惧。通过TUGT（定时起立行走测试手册）和TUG（定时起立行走测试认知）评估双重任务。确定了TUGT和TUGT的双重任务成本（DTC）。使用STATISTICA软件包v.10完成统计分析。
结果
在进行单任务活动、双重任务活动以及步速方面，受MCI影响的个体与未受影响的个体在步态测试结果上存在显著差异。与未受MCI影响的受试者相比，MCI组的双重任务成本手册（DTC）显著更高。MCI组DTC结果约25%的方差可由单任务条件下（TUGT）的步态表现来解释。对于双重任务成本认知（DTC），该值约为10%。DTC每变化1%，TUGT约变化0.5秒，而DTC每变化1%，TUGT行走时间约变化0.35秒。
结论
个体功能能力影响双重任务表现，尤其是运动-运动任务。受MCI影响的受试者的双重任务成本显著降低，在需要视觉记忆的运动-运动任务中比在运动-认知任务中更依赖步速。
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