Department of Ophthalmology, Xi'an People's Hospital (Xi'an Fourth Hospital), 21 Jiefang Road, Xi'an, Shaanxi, 710061, China.
Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, Shaanxi, 710061, China.
BMC Geriatr. 2022 Jun 6;22(1):487. doi: 10.1186/s12877-022-03189-y.
Walking impairment, a common health problem among older adults, has been linked to poor vision and mental health. This study aimed to investigate the associations of walking impairment with visual impairment, depression, and cognitive function in older adults.
A total of 1,489 adults aged 60 years and older who had participated in the National Health and Examination Survey (NHANES) 2013-2014 in the United States were included. Multivariate logistic regression models were used to examine the associations of walking impairment with visual impairment, depression, and four subdomains of cognitive function. Sample weights were used to ensure the generalizability of the results.
Among all the participants (median age = 68 years; 53.7% women), 17.5% reported walking impairment. Walking impairment was significantly associated with visual impairment (adjusted odds ratio [aOR] = 2.76; 95% CI: 1.47-5.20) and depression (aOR = 4.66; 95% CI: 3.11-6.99). Walking impairment was only associated with the Digit Symbol Substitution (DSST) subdomain of cognitive function in total participants (aOR = 0.97; 95% CI: 0.95-0.99) and in non-Hispanic white adults (aOR = 0.96; 95% CI: 0.94-0.98). Participants with two or three impairment indicators had a higher OR of walking impairment (aOR = 3.64, 95% CI = 2.46-5.38) than those with 0-1 (reference group) impairment indicator.
Walking impairment was associated with visual impairment, depression, and cognitive impairment in American older adults and also positively associated with the number of impairment indicators. The association between walking impairment and cognitive impairment varied according to race. Evaluations of vision, cognition, and depression should be conducted among older adults with walking impairment, and the needs of older adults should be provided in the evaluations alongside information on the biological aspects of their particular race.
行走障碍是老年人常见的健康问题，与视力和心理健康不佳有关。本研究旨在探讨老年人行走障碍与视力障碍、抑郁和认知功能的关系。
本研究共纳入了 2013-2014 年美国国家健康和营养检查调查（NHANES）中 1489 名 60 岁及以上的成年人。采用多变量逻辑回归模型，分析了行走障碍与视力障碍、抑郁和认知功能的四个子领域之间的关系。采用样本权重确保结果的普遍性。
在所有参与者中（中位年龄 68 岁；53.7%为女性），17.5%的人报告有行走障碍。行走障碍与视力障碍（调整后的优势比[aOR] 2.76；95%置信区间：1.47-5.20）和抑郁（aOR 4.66；95%置信区间：3.11-6.99）显著相关。在所有参与者和非西班牙裔白人中，行走障碍仅与数字符号替代（DSST）认知功能子领域相关（aOR 0.97；95%置信区间：0.95-0.99；aOR 0.96；95%置信区间：0.94-0.98）。有两个或三个障碍指标的参与者比只有 0-1 个（参考组）障碍指标的参与者发生行走障碍的优势比（aOR 3.64；95%置信区间 2.46-5.38）更高。
行走障碍与美国老年人的视力障碍、抑郁和认知障碍有关，且与障碍指标的数量呈正相关。行走障碍与认知障碍的关系因种族而异。在评估有行走障碍的老年人时，应进行视力、认知和抑郁评估，并在评估中提供与特定种族的生物学方面相关的信息，以满足老年人的需求。
