Yasuoka Mikako, Tange Chikako, Nishita Yukiko, Tomida Makiko, Watanabe Ryota, Shimokata Hiroshi, Otsuka Rei, Kojima Masayo
Department of Frailty Research, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.
Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.
Ann Geriatr Med Res. 2023 Mar;27(1):58-65. doi: 10.4235/agmr.22.0142. Epub 2023 Mar 9.
This study evaluated the chronological changes in physical and cognitive functions in middle-aged and older adults with and without rheumatoid arthritis (RA).
This population-based case-control longitudinal study included individuals aged 40-79 years at baseline who agreed to participate. We identified 42 participants with RA and randomly selected 84 age- and sex-matched controls. Physical function was assessed according to gait speed, grip strength, and skeletal muscle mass. Cognitive function was assessed based on the information, similarities, picture completion, and digit symbol substitution test scores of the Wechsler Adult Intelligence Scale-Revised Short Form. The general linear mixed models comprised the fixed effects of the intercept, case, age, time in years since baseline, and case×time interaction, which were used to examine longitudinal changes in physical and cognitive functions.
Regardless of RA status, grip strength decreased and the picture completion score increased in the group aged <65 years, while skeletal muscle mass index and gait speed decreased in the group aged ≥65 years. The interaction of case×follow-up years for grip strength in the group aged ≥65 years was significant (p=0.03). The decline in grip strength in the control group (slope=-0.45) was greater than that in the RA group (slope=-0.19).
Chronological changes in physical and cognitive functions were comparable between participants with and without RA; however, the decline in grip strength in the control group was greater among older adults with RA.
本研究评估了患有和未患类风湿关节炎(RA)的中老年人身体和认知功能随时间的变化。
这项基于人群的病例对照纵向研究纳入了基线时年龄在40 - 79岁且同意参与的个体。我们确定了42名类风湿关节炎患者,并随机选取了84名年龄和性别匹配的对照。根据步速、握力和骨骼肌质量评估身体功能。基于韦氏成人智力量表修订简式的信息、相似性、图片完成和数字符号替换测试分数评估认知功能。通用线性混合模型包括截距、病例、年龄、自基线起的年数以及病例×时间交互作用的固定效应,用于检验身体和认知功能的纵向变化。
无论是否患有类风湿关节炎,<65岁组的握力下降且图片完成分数增加,而≥65岁组的骨骼肌质量指数和步速下降。≥65岁组握力的病例×随访年数交互作用显著(p = 0.03)。对照组握力的下降幅度(斜率 = -0.45)大于类风湿关节炎组(斜率 = -0.19)。
患有和未患类风湿关节炎的参与者身体和认知功能的时间变化具有可比性;然而,在患有类风湿关节炎的老年人中,对照组握力的下降幅度更大。