六年生理认知衰退综合征的转变：来自宜兰纵向老化研究的结果。

Six-year transition of physio-cognitive decline syndrome: Results from I-Lan Longitudinal Aging Study.

机构信息

Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 115, Section 2, Li-Nong Street, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan County, Taiwan.

Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, No. 115, Section 2, Li-Nong Street, Taipei, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Arch Gerontol Geriatr. 2022 Sep-Oct;102:104743. doi: 10.1016/j.archger.2022.104743. Epub 2022 Jun 3.

DOI:10.1016/j.archger.2022.104743

PMID:35687948

Abstract

OBJECTIVES

To explore associations between PCDS, incident dementia and mortality risk and evaluate the potential of its reversibility.

METHODS

963 participants from the I-Lan Longitudinal Aging Study were followed up for 6 years for analysis. A subsample of 513 participants was invited to participate 3 years earlier. The 1.5 standard deviation lower age- and education-matched norms of neuropsychiatric assessments determined cognitive impairment. Weakness and slowness were defined by the Asian Working Group for Sarcopenia 2019. PCDS was defined as cognitive impairment plus mobility impairment, i.e., weakness and/or slowness.

RESULTS

The prevalence of PCDS was 19.0% among 1709 participants aged 63.5 ± 9.0 years (from 50 to 90 years) and increased with age (14.7% in people aged 50-64 years, 19.5% in people aged 65-74 years, 36.7% in people aged 75-84 years and 45.5% in people aged ≥ 85 years, p for trend <0.001). 13.6% and 8.3% of participants had improved PCDS conditions in 513 participants at 3-year and in 963 participants at 6-year assessments. Of 118 participants with PCDS at baseline,36 (30.5%) returned to non-PCDS in 6 years. Being female and having good nutrition were potential associated factors. During the mean follow-up period of 5.9 ± 0.9 years, 182 deaths occurred in the 10,065 person-years. PCDS could predict the 6-year risk of mortality (HR 1.56, 95% CI 1.02-2.39, p = 0.012) and 6-year incident dementia (OR 3.42, 95% CI: 1.41-8.29, p = 0.007).

CONCLUSIONS

PCDS significantly predict 6-year mortality and 6-year incident dementia. Reversibility of PCDS made it as an optimal target for intervention and prevention.

摘要

目的

探讨认知功能下降合并躯体运动障碍（PCDS）与痴呆和死亡风险的相关性，并评估其可逆性。

方法

本研究对来自宜兰县老化纵向研究的 963 名参与者进行了 6 年的随访分析，其中 513 名参与者被邀请在 3 年前参与研究。通过神经精神评估的 1.5 个标准差低年龄和教育匹配的标准来确定认知障碍。采用 2019 年亚洲肌肉减少症工作组定义的衰弱和缓慢来定义衰弱和缓慢。PCDS 定义为认知障碍合并躯体运动障碍，即衰弱和/或缓慢。

结果

在 1709 名年龄为 63.5±9.0 岁（50-90 岁）的参与者中，PCDS 的患病率为 19.0%，且随年龄增长而增加（50-64 岁人群为 14.7%，65-74 岁人群为 19.5%，75-84 岁人群为 36.7%，≥85 岁人群为 45.5%，p 趋势<0.001）。在 513 名参与者的 3 年评估和 963 名参与者的 6 年评估中，分别有 13.6%和 8.3%的参与者的 PCDS 状况得到改善。在基线时患有 PCDS 的 118 名参与者中，有 36 名（30.5%）在 6 年内恢复为非 PCDS 状态。女性和良好的营养状况是潜在的相关因素。在平均 5.9±0.9 年的随访期间，10065 人年中有 182 人死亡。PCDS 可预测 6 年死亡率（HR 1.56，95%CI 1.02-2.39，p=0.012）和 6 年新发痴呆（OR 3.42，95%CI：1.41-8.29，p=0.007）。