Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC.
Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan, ROC.
BMC Geriatr. 2023 Jan 13;23(1):24. doi: 10.1186/s12877-023-03741-4.
Few studies emphasize on predictors of incident cognitive frailty (CF) and examine relationships between various gait characteristics and CF. Therefore, we conducted a 2-year prospective study to investigate potential predictors, including gait characteristics, of incident reversible CF (RCF) and potentially RCF (PRCF) among Taiwanese older adults.
Eligible participants were individuals aged ≥ 65 years, who could ambulate independently, and did not have RCF/PRCF at the baseline. The baseline assessment collected information on physical frailty and cognitive measures, in addition to sociodemographic and lifestyle characteristics, preexisting comorbidities and medications, gait characteristics, Tinetti's balance, balance confidence as assessed by Activities-specific Balance Confidence (ABC) scale, and the depressive status as assessed by the Geriatric Depression Scale. The Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, and Digit Symbol Substitution Test were used to evaluate cognitive functions. Incident RCF and PRCF were ascertained at a 2-year follow-up assessment.
Results of the multinomial logistic regression analysis showed that incident RCF was significantly associated with older age (odds ratio [OR] = 1.05) and lower ABC scores (OR = 0.97). Furthermore, incident PRCF was significantly associated with older age (OR = 1.07), lower ABC scores (OR = 0.96), the presence of depression (OR = 3.61), lower MMSE scores (OR = 0.83), slower gait velocity (OR = 0.97), and greater double-support time variability (OR = 1.09).
Incident RCF was independently associated with older age and lower balance confidence while incident PRCF independently associated with older age, reduced global cognition, the presence of depression, slower gait velocity, and greater double-support time variability. Balance confidence was the only modifiable factor associated with both incident RCF and PRCF.
很少有研究强调认知脆弱（CF）的预测因素，并检查各种步态特征与 CF 之间的关系。因此，我们进行了一项为期 2 年的前瞻性研究，以调查台湾老年人中潜在的认知脆弱（RCF）和潜在的认知脆弱（PRCF）的潜在预测因素，包括步态特征。
合格的参与者是年龄≥65 岁的个体，他们可以独立行走，且基线时没有 RCF/PRCF。基线评估收集了身体脆弱性和认知测量、社会人口统计学和生活方式特征、预先存在的合并症和药物、步态特征、Tinetti 的平衡、活动特定平衡信心（ABC）量表评估的平衡信心、以及老年抑郁量表评估的抑郁状况的信息。采用简易精神状态检查（MMSE）、马特斯痴呆评定量表和数字符号替代测验评估认知功能。在 2 年随访评估时确定了 RCF 和 PRCF 的发病情况。
多变量逻辑回归分析的结果表明，RCF 的发病与年龄较大（优势比[OR] = 1.05）和 ABC 评分较低（OR = 0.97）显著相关。此外，PRCF 的发病与年龄较大（OR = 1.07）、ABC 评分较低（OR = 0.96）、抑郁（OR = 3.61）、MMSE 评分较低（OR = 0.83）、步行速度较慢（OR = 0.97）和双支撑时间变异性较大（OR = 1.09）显著相关。
RCF 的发病与年龄较大和平衡信心较低独立相关，而 PRCF 的发病与年龄较大、整体认知能力下降、抑郁的存在、步行速度较慢和双支撑时间变异性较大独立相关。平衡信心是与 RCF 和 PRCF 发病都相关的唯一可改变因素。
