Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Gait Posture. 2022 Jul;96:67-72. doi: 10.1016/j.gaitpost.2022.05.014. Epub 2022 May 13.
BACKGROUND & AIMS: Slow gait speed during Walking While Talking (walking while reciting alternate letters of the alphabet; WWT) is associated with an increased risk of developing dementia and falls. The aim of this study was to examine longitudinal changes in WWT-speed and to identify risk factors that may modify the rate of change in WWT-speed.
A total of 431 older participants (55.7% female; M Age=76.8 ± 6.4 years; mean follow up 2.1 ± 1.8 years) enrolled in the Central Control of Mobility in Aging study were examined. WWT-speed (cm/s) was measured with a computerized walkway. The following baseline measures were examined as risk factors: demographics [age, sex, education], medical illnesses [hypertension, diabetes, cardiac arrhythmias, history of stroke, Parkinson's disease, kidney disease, arthritis], cognitive functions [global cognition, executive function, processing speed], physical and sensory functions [unipedal stance time, gait speed during single task walking, visual acuity], psychological variables [depression, anxiety] and falls. Linear mixed effect models were used to examine 1) change in WWT-speed over time, and 2) risk factors associated with change in WWT-speed over time.
WWT-speed declined in an accelerating non-linear fashion over time after adjusting for baseline age, sex and education. The rate of decline in WWT-speed was modified by older age (b -0.16 95%CI -0.22, -0.09), poorer balance (b -1.73 95%CI -2.57, -0.90), and faster gait speed during single task walking (b -0.06 95%CI -0.08, -0.04).
This study identified fixed and modifiable risk factors of faster decline in WWT-speed over time in community-residing older adults.
在边走边说测试（边走边背诵字母表的交替字母；WWT）中，缓慢的步速与痴呆和跌倒风险的增加有关。本研究旨在检查 WWT 速度的纵向变化，并确定可能改变 WWT 速度变化率的风险因素。
共纳入 431 名年龄较大的参与者（55.7%为女性；M 年龄=76.8±6.4 岁；平均随访时间 2.1±1.8 年），在老龄化的中央运动控制研究中进行了检查。使用计算机化步道测量 WWT 速度（cm/s）。将以下基线测量值作为风险因素进行检查：人口统计学（年龄、性别、教育）、医学疾病（高血压、糖尿病、心律失常、中风史、帕金森病、肾病、关节炎）、认知功能（整体认知、执行功能、处理速度）、身体和感官功能（单脚站立时间、单任务行走时的步态速度、视力）、心理变量（抑郁、焦虑）和跌倒。线性混合效应模型用于检查 1）随时间变化的 WWT 速度变化，以及 2）与随时间变化的 WWT 速度变化相关的风险因素。
在调整基线年龄、性别和教育后，WT 速度随时间呈加速非线性下降。年龄较大（b=-0.16 95%CI-0.22，-0.09）、平衡能力较差（b=-1.73 95%CI-2.57，-0.90）和单任务行走时的步态速度较快（b=-0.06 95%CI-0.08，-0.04）会改变 WWT 速度的下降速度。
本研究确定了社区居住的老年人中 WWT 速度随时间更快下降的固定和可改变的风险因素。
