Chantanachai Thanwarat, Sturnieks Daina L, Lord Stephen R, Menant Jasmine, Delbaere Kim, Sachdev Perminder S, Brodaty Henry, Humburg Peter, Taylor Morag E
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia.
School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
Int Psychogeriatr. 2024 Apr;36(4):306-316. doi: 10.1017/S1041610223000315. Epub 2023 Apr 20.
We examined longitudinal changes in cognitive and physical function and associations between change in function and falls in people with and without mild cognitive impairment (MCI).
Prospective cohort study with assessments every 2 years (for up to 6 years).
Community, Sydney, Australia.
Four hundred and eighty one people were classified into three groups: those with MCI at baseline and MCI or dementia at follow-up assessments ( = 92); those who fluctuated between cognitively normal and MCI throughout follow-up (cognitively fluctuating) ( = 157), and those who were cognitively normal at baseline and all reassessments ( = 232).
Cognitive and physical function measured over 2-6 years follow-up. Falls in the year following participants' final assessment.
In summary, 27.4%, 38.5%, and 34.1% of participants completed 2, 4, and 6 years follow-up of cognitive and physical performance, respectively. The MCI and cognitive fluctuating groups demonstrated cognitive decline, whereas the cognitively normal group did not. The MCI group had worse physical function than the cognitively normal group at baseline but decline over time in physical performance was similar across all groups. Decline in global cognitive function and sensorimotor performance were associated with multiple falls in the cognitively normal group and decline in mobility (timed-up-and-go test) was associated with multiple falls across the whole sample.
Cognitive declines were not associated with falls in people with MCI and fluctuating cognition. Declines in physical function were similar between groups and decline in mobility was associated with falls in the whole sample. As exercise has multiple health benefits including maintaining physical function, it should be recommended for all older people. Programs aimed at mitigating cognitive decline should be encouraged in people with MCI.
我们研究了有和没有轻度认知障碍（MCI）的人群认知和身体功能的纵向变化，以及功能变化与跌倒之间的关联。
前瞻性队列研究，每2年进行一次评估（最长6年）。
澳大利亚悉尼的社区。
481人被分为三组：基线时患有MCI且随访评估时患有MCI或痴呆症的人群（n = 92）；在整个随访过程中认知状态在正常和MCI之间波动的人群（认知波动组）（n = 157），以及基线时和所有重新评估时认知正常的人群（n = 232）。
在2至6年的随访期间测量认知和身体功能。在参与者最后一次评估后的一年内发生的跌倒情况。
总体而言，分别有27.4%、38.5%和34.1%的参与者完成了2年、4年和6年的认知和身体表现随访。MCI组和认知波动组表现出认知能力下降，而认知正常组则没有。MCI组在基线时的身体功能比认知正常组差，但随着时间推移，所有组的身体表现下降情况相似。在认知正常组中，整体认知功能和感觉运动表现的下降与多次跌倒相关，而在整个样本中，移动能力下降（计时起立行走测试）与多次跌倒相关。
MCI患者和认知波动人群的认知能力下降与跌倒无关。各组之间身体功能下降情况相似，移动能力下降与整个样本中的跌倒相关。由于运动对健康有多种益处，包括维持身体功能，因此应建议所有老年人进行运动。对于MCI患者，应鼓励开展旨在减轻认知能力下降的项目。
