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轻度至中度阿尔茨海默病患者跌倒风险与衰弱、肌少症和平衡障碍的关系

Relationships of Fall Risk With Frailty, Sarcopenia, and Balance Disturbances in Mild-to-Moderate Alzheimer's Disease.

作者信息

Güner Oytun Merve, Topuz Semra, Baş Arzu Okyar, Çöteli Süheyla, Kahyaoğlu Zeynep, Boğa İlker, Ceylan Serdar, Doğu Burcu Balam, Cankurtaran Mustafa, Halil Meltem

机构信息

Division of Geriatrics, Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey.

Department of Physical Therapy and Rehabilitation, Hacettepe University Faculty of Health Sciences, Ankara, Turkey.

出版信息

J Clin Neurol. 2023 May;19(3):251-259. doi: 10.3988/jcn.2022.0219. Epub 2023 Jan 2.

Abstract

BACKGROUND AND PURPOSE

Cognitive impairment is one of the main risk factors for falls, and hence it commonly coexists with balance issues. Frailty and sarcopenia are intertwined and prevalent in dementia, and are closely related to falls. We aimed to determine the relationships of the fall risk with balance disturbances, sarcopenia, and frailty in mild-to-moderate Alzheimer's disease (AD).

METHODS

The study enrolled 56 patients with probable AD. A comprehensive geriatric assessment was performed, and muscle strength and mass, performance status, gait, and balance were evaluated. All parameters were compared between fallers and nonfallers with AD.

RESULTS

Fallers comprised 53.6% of the study population. The demographic features and AD stages did not differ between fallers and nonfallers. Fallers were more frail than nonfallers (<0.05). Frailty was found to be independently associated with fall history (odds ratio=2.15, 95% confidence interval=1.20-3.82, =0.031). We found that falls were not associated with AD stage, muscle mass and function, balance and geriatric syndromes except urinary incontinence in patients with AD (>0.05).

CONCLUSIONS

We found that falls were not influenced by AD stage. Both physical and cumulative frailty were strongly associated with falls in patients with mild-to-moderate AD.

摘要

背景与目的

认知障碍是跌倒的主要风险因素之一,因此它常与平衡问题并存。衰弱和肌肉减少症在痴呆症中相互交织且普遍存在,并且与跌倒密切相关。我们旨在确定轻度至中度阿尔茨海默病(AD)患者的跌倒风险与平衡障碍、肌肉减少症和衰弱之间的关系。

方法

该研究纳入了56例可能患有AD的患者。进行了全面的老年综合评估,并评估了肌肉力量和质量、身体功能状态、步态和平衡。对AD患者中跌倒者和未跌倒者的所有参数进行了比较。

结果

跌倒者占研究人群的53.6%。跌倒者和未跌倒者的人口统计学特征及AD分期无差异。跌倒者比未跌倒者更衰弱(P<0.05)。发现衰弱与跌倒史独立相关(比值比=2.15,95%置信区间=1.20-3.82,P=0.031)。我们发现,AD患者的跌倒与AD分期、肌肉质量和功能、平衡及老年综合征(尿失禁除外)无关(P>0.05)。

结论

我们发现跌倒不受AD分期影响。身体衰弱和累积衰弱均与轻度至中度AD患者的跌倒密切相关。

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