Wang Xiaoqin, Yu Wuhan, Huang Lihong, Yan Mengyu, Zhang Wenbo, Song Jiaqi, Liu Xintong, Yu Weihua, Lü Yang
Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Institutes of Neuroscience, Chongqing Medical University, Chongqing 400016, China.
Brain Sci. 2023 Jan 16;13(1):154. doi: 10.3390/brainsci13010154.
Background: Screening cognitive impairment is complex and not an appliance for early screening. Gait performance is strongly associated with cognitive impairment. Objectives: We aimed to explore gait indicators that could potentially screen cognitive dysfunction. Methods: A total of 235 subjects were recruited from June 2021 to June 2022. Four gait tasks, including the walking test, the timed “Up & Go” test (TUG), foot pressure balance (FPB), and one-legged standing with eyes closed test (OLS-EC), were performed. Moreover, in the walking test, participants were instructed to walk at their usual pace for the single-gait test. For the dual-task tests, participants walked at their usual pace while counting backward from 100 by 1s. The data were analyzed by the independent sample t-test, univariate and multivariate logistic regression, a linear trend, stratified and interaction analysis, the receiver operating characteristic (ROC) curve, and Pearson’s correlations. Results: Among the 235 participants, 81 (34.5%) were men and 154 (65.5%) were women. The mean age of participants was 72 ± 7.836 years. The control, MCI, mild AD, and severe AD groups had means of 71, 63, 71, and 30, respectively. After adjusting for age, sex, education, and body mass index (BMI), the dual-task toe-off-ground angle (TOA) (odds ratio (OR) = 0.911, 95% confidence interval (CI): 0.847, 0.979), single-task TOA (OR = 0.904, 95% CI: 0.841−0.971), and the timed “Up & Go” time (TUGT) (OR = 1.515, 95% CI: 1.243−1.846) were significantly associated with an increased risk of cognitive impairment. In addition, the trend test and stratified analysis results had no significant differences (all p > 0.05). The area under the roc curve (AUC) values of TOA in the dual-task and TUGT were 0.812 and 0.847, respectively. Additionally, TOA < 36.75° in the dual-task, TOA < 38.90° in the single-task, and TUGT > 9.83 seconds (s) are likely to indicate cognitive impairment. The cognitive assessment scale scores were significantly correlated with TOA (all r > 0.3, p < 0.001) and TUGT (all r > 0.2), respectively. Conclusion: TOA and TUGT scores are, in some circumstances, associated with cognitive impairment; therefore, they can be used as simple initial screenings to identify patients at risk.
认知障碍筛查复杂，并非早期筛查的适用手段。步态表现与认知障碍密切相关。目的：我们旨在探索可能用于筛查认知功能障碍的步态指标。方法：2021年6月至2022年6月共招募了235名受试者。进行了四项步态任务，包括步行测试、定时起立行走测试（TUG）、足底压力平衡（FPB）和闭眼单腿站立测试（OLS - EC）。此外，在步行测试中，参与者被要求以平常的步伐进行单步态测试。对于双任务测试，参与者以平常的步伐行走，同时从100开始倒数，每次减1。数据通过独立样本t检验、单变量和多变量逻辑回归、线性趋势、分层和交互分析、受试者工作特征（ROC）曲线以及Pearson相关性进行分析。结果：在235名参与者中，81名（34.5%）为男性，154名（65.5%）为女性。参与者的平均年龄为72±7.836岁。对照组、轻度认知障碍组、轻度阿尔茨海默病组和重度阿尔茨海默病组的平均年龄分别为71岁、63岁、71岁和30岁。在调整年龄、性别、教育程度和体重指数（BMI）后，双任务离地趾角（TOA）（比值比（OR）=0.911，95%置信区间（CI）：0.847，0.979）、单任务TOA（OR = 0.904，95% CI：0.841 - 0.971）以及定时起立行走时间（TUGT）（OR = 1.515，95% CI：1.243 - 1.846）与认知障碍风险增加显著相关。此外，趋势检验和分层分析结果无显著差异（所有p>0.05）。双任务中TOA的ROC曲线下面积（AUC）值和TUGT分别为0.812和0.847。此外，双任务中TOA<36.75°、单任务中TOA<38.90°以及TUGT>9.83秒可能表明存在认知障碍。认知评估量表得分分别与TOA（所有r>0.3，p<0.001）和TUGT（所有r>0.2）显著相关。结论：在某些情况下，TOA和TUGT得分与认知障碍相关；因此，它们可作为简单的初始筛查手段，用于识别有风险的患者。
