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简短体能电池测试与轻度认知障碍对社区居住老年人跌倒影响的中介作用。

Short Physical Performance Battery and Mediation of the Effect of Mild Cognitive Impairment on Falls by Community-Dwelling Older Adults.

机构信息

Departments of Public Health and Health Sciences (Amini) and Occupational Therapy (Counseller, Taylor, Naimi), University of Michigan, Flint; Department of Psychology, University of Michigan, Ann Arbor (Fayyad).

出版信息

J Neuropsychiatry Clin Neurosci. 2023 Winter;35(1):59-68. doi: 10.1176/appi.neuropsych.21050145. Epub 2022 Jun 10.

Abstract

OBJECTIVE

The authors examined the association among cognitive function, falling, and physical performance among community-dwelling older adults (ages ≥65 years).

METHODS

Eight waves of the National Health and Aging Trends Study (NHATS; 2011-2018) were assessed, with 1,225 respondents who participated in all waves. The outcomes were self-reported number of falls and NHATS Short Physical Performance Battery (SPPB) score. The Clock Drawing Test measured participants' executive function, and immediate and delayed word recall tests assessed memory.

RESULTS

The analyses indicated no direct correlation between executive function and fall risk when controlled for contributing factors. However, executive function and memory significantly predicted the risk for poor physical performance, defined by the NHATS SPPB score. The interaction between pain medication and memory worsened poor physical performance among participants with mild and severe memory impairment, as well as among those with mild to moderate impairment in executive function.

CONCLUSIONS

Screening older adults living in the community for executive function, memory impairment, and physical performance can predict the risk for falls and the subsequent consequences of falling.

摘要

目的

本研究旨在探讨认知功能、跌倒和身体机能在社区居住的老年人(年龄≥65 岁)中的相关性。

方法

共评估了国家健康老龄化趋势研究(NHATS)的 8 个波次(2011-2018 年),共有 1225 名参与者参加了所有波次。结果包括自我报告的跌倒次数和 NHATS 短体性能电池(SPPB)评分。时钟绘图测试评估了参与者的执行功能,即时和延迟单词回忆测试评估了记忆。

结果

分析表明,在控制了其他因素后,执行功能与跌倒风险之间没有直接相关性。然而,执行功能和记忆显著预测了 NHATS SPPB 评分定义的身体机能不良的风险。在轻度和重度记忆障碍以及轻度至中度执行功能障碍的参与者中,疼痛药物治疗和记忆之间的相互作用使身体机能不良的风险恶化。

结论

对居住在社区的老年人进行执行功能、记忆障碍和身体机能筛查可以预测跌倒风险及其随后的跌倒后果。

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