认知正常和轻度认知障碍的亚洲社区老年人中，简单身体表现测试与整体和特定认知功能的关联存在差异：一项横断面队列研究。
Differential associations between simple physical performance tests with global and specific cognitive functions in cognitively normal and mild cognitive impairment: a cross-sectional cohort study of Asian community-dwelling older adults.
机构信息
Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Edson College of Nursing and Health Innovation, Arizona State University, Health North, Suite 301, 550 N 3rd Street, Phoenix, AZ, 85004, USA.
出版信息
BMC Geriatr. 2022 Oct 13;22(1):798. doi: 10.1186/s12877-022-03434-4.
BACKGROUND
Physical performance declines and executive dysfunctions are predictors of dementia. However, their associations are not well understood in Asian older adults without dementia (cognitively normal [CN] and mild cognitive impairment [MCI]), especially in a single study.
OBJECTIVE
Examine the associations between physical performance measures with executive function (EF)-based and non-EF-based neurocognitive tests and whether preclinical dementia cognitive status i.e., CN and MCI, moderated these associations.
METHODS
We examined cross-sectional cohort of 716 community-dwelling older adults without dementia (CN = 562 and MCI = 154) using multivariable linear regression models. We associated three simple physical performance measures, namely timed-up-and-go (TUG), fast gait speed (FGS), and 30-s chair stand test (30 s-CST), with a comprehensive neurocognitive test battery measuring EF and non-EF cognitive functions. Moderating effects of cognitive status on the associations were examined. In all models, we controlled for pertinent covariates, including age, education, medical and psychiatric status.
RESULTS
Upon controlling for covariates, TUG was most strongly and positively associated with multiple EF-based neurocognitive tests, followed by FGS, with 30 s-CST having the weakest associations. For all physical performance measures, no significant associations with non-EF-based neurocognitive tests were detected. Cognitive status significantly moderated the associations between all physical measures and several neurocognitive tests, with stronger associations in the MCI than CN.
CONCLUSION
Compared to FGS and 30 s-CST, TUG had the most robust associations with multiple EF-based cognitive functions. Given their differential associations with global and detailed neurocognitive tests and significant moderating effects of cognitive status, findings highlight a need to carefully consider the choices of simple physical performance tests when using these tests with a heterogenous group of community-dwelling older adults without dementia.
背景
身体机能下降和执行功能障碍是痴呆的预测因素。然而，在没有痴呆（认知正常[CN]和轻度认知障碍[MCI]）的亚洲老年人中，它们之间的关联尚未得到很好的理解，特别是在单一研究中。
目的
检查身体机能测试与基于执行功能（EF）和非 EF 的神经认知测试之间的关联，以及是否存在临床前痴呆认知状态（即 CN 和 MCI）会调节这些关联。
方法
我们使用多变量线性回归模型，对 716 名无痴呆的社区居住老年人进行了横断面队列研究（CN=562 名，MCI=154 名）。我们将三种简单的身体机能测试，即计时起立行走（TUG）、快速步态速度（FGS）和 30 秒坐站测试（30 s-CST），与测量 EF 和非 EF 认知功能的综合神经认知测试组合进行关联。检验认知状态对关联的调节作用。在所有模型中，我们都控制了相关的协变量，包括年龄、教育、医疗和精神状态。
结果
在控制了协变量后，TUG 与多项基于 EF 的神经认知测试的相关性最强且呈正相关，其次是 FGS，而 30 s-CST 的相关性最弱。对于所有身体机能测试，都未发现与非 EF 基于神经认知测试的显著关联。认知状态显著调节了所有身体测量指标与多种神经认知测试之间的关联，在 MCI 中比 CN 中关联更强。
结论
与 FGS 和 30 s-CST 相比，TUG 与多项基于 EF 的认知功能的相关性最强。鉴于它们与整体和详细的神经认知测试的不同关联，以及认知状态的显著调节作用，研究结果强调，在使用这些测试对无痴呆的社区居住老年人进行异质群体研究时，需要仔细考虑简单身体机能测试的选择。
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