Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
Exp Gerontol. 2022 Jun 15;163:111776. doi: 10.1016/j.exger.2022.111776. Epub 2022 Mar 24.
Mobility is important for independence in older age. While brain health correlates of objectively measured mobility-related features like gait and balance have been reported, we aimed to test neuroimaging and cognitive correlates of subjective measures of mobility-related confidence.
We carried out a cross-sectional observational study comprised of N = 29 cognitively unimpaired older adult participants, mean age 75.8 ± 5.8, 52% female, 24% non-white. We measured cognition, hippocampal volume, white matter hyperintensities, cerebral amyloid-β (Aβ), and gait and balance confidence. We tested associations using unadjusted Spearman correlations and correlations partialling out covariates of interest one at a time.
Greater gait confidence was associated with better attention (unadjusted ρ = 0.37, p = 0.05; partially attenuated by adjustment for age, APOE4, anxiety, motivation, gait speed, or Aβ); executive performance (unadjusted ρ = 0.35, p = 0.06; partially attenuated by adjustment for age, APOE4, gait speed, or Aβ); and lower Aβ levels (unadjusted ρ = -0.40, p = 0.04; partially attenuated by adjustment for age, depressive symptoms, motivation, or gait speed). Greater balance confidence was associated with better global cognition (unadjusted ρ = 0.41, p = 0.03; partially attenuated by adjustment for APOE4, gait speed, or Aβ); attention (unadjusted ρ = 0.46, p = 0.01; robust to adjustment); and lower Aβ levels (unadjusted ρ = -0.35, p = 0.07; partially attenuated by adjustment for age, education, APOE4, depressive symptoms, anxiety, motivation, or gait speed).
Self-reported mobility-related confidence is associated with neuroimaging and cognitive measures and would be easy for providers to use in clinical evaluations. These associations should be further evaluated in larger samples, and longitudinal studies can help determine temporality of declines.
行动能力对于老年人的独立生活很重要。虽然已有研究报告了与步态和平衡等客观测量的行动能力相关特征相关的大脑健康指标，但我们旨在测试与行动能力相关的自信心的主观测量的神经影像学和认知相关性。
我们进行了一项横断面观察性研究，纳入了 29 名认知正常的老年参与者，平均年龄为 75.8±5.8 岁，52%为女性，24%为非白人。我们测量了认知、海马体积、脑白质高信号、脑淀粉样蛋白-β（Aβ）以及步态和平衡的自信心。我们使用未调整的斯皮尔曼相关系数和逐步调整感兴趣的协变量一次一个的相关分析来测试相关性。
更大的步态自信心与更好的注意力（未调整 ρ=0.37，p=0.05；通过调整年龄、APOE4、焦虑、动机、步态速度或 Aβ部分减弱）；执行表现（未调整 ρ=0.35，p=0.06；通过调整年龄、APOE4、步态速度或 Aβ部分减弱）；和较低的 Aβ水平（未调整 ρ=-0.40，p=0.04；通过调整年龄、抑郁症状、动机或步态速度部分减弱）有关。更大的平衡自信心与更好的总体认知（未调整 ρ=0.41，p=0.03；通过调整 APOE4、步态速度或 Aβ部分减弱）；注意力（未调整 ρ=0.46，p=0.01；调整后仍然稳健）；和较低的 Aβ水平（未调整 ρ=-0.35，p=0.07；通过调整年龄、教育程度、APOE4、抑郁症状、焦虑、动机或步态速度部分减弱）有关。
自我报告的与行动能力相关的信心与神经影像学和认知测量有关，并且对于提供者在临床评估中使用会很方便。这些相关性应在更大的样本中进一步评估，并且纵向研究可以帮助确定下降的时间顺序。
