Weng Wei-Han, Yang Yea-Ru, Yeh Nai-Chen, Ku Pei-Hsin, Wang Po-Shan, Liao Ying-Yi, Wang Ray-Yau
Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Neurology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan.
Front Aging Neurosci. 2023 Jun 2;15:1177082. doi: 10.3389/fnagi.2023.1177082. eCollection 2023.
Growing evidence shows the cognitive function influences the motor performance. The prefrontal cortex (PFC) as a part of the executive locomotor pathway is also important for cognitive function. This study investigated the differences in motor function and brain activity among older adults with different cognitive levels, and examined the significance of cognition on motor functions.
Normal control (NC), individuals with mild cognitive impairment (MCI) or mild dementia (MD) were enrolled in this study. All participants received a comprehensive assessment including cognitive function, motor function, PFC activity during walking, and fear of fall. The assessment of cognitive function included general cognition, attention, executive function, memory, and visuo-spatial. The assessment of motor function included timed up and go (TUG) test, single walking (SW), and cognitive dual task walking (CDW).
Individuals with MD had worse SW, CDW and TUG performance as compared to individuals with MCI and NC. These gait and balance performance did not differ significantly between MCI and NC. Motor functions all correlated with general cognition, attention, executive function, memory, and visuo-spatial ability. Attention ability measured by trail making test A (TMT-A) was the best predictor for TUG and gait velocity. There were no significant differences in PFC activity among three groups. Nevertheless, the PFC activated more during CDW as compared with SW in individuals with MCI ( = 0.000), which was not demonstrated in the other two groups.
MD demonstrated worse motor function as compared to NC and MCI. The greater PFC activity during CDW in MCI may be considered as a compensatory strategy for maintaining the gait performance. Motor function was related to the cognitive function, and the TMT A was the best predictor for the gait related performance in present study among older adults.
越来越多的证据表明认知功能会影响运动表现。前额叶皮层（PFC）作为执行运动通路的一部分，对认知功能也很重要。本研究调查了不同认知水平的老年人在运动功能和大脑活动方面的差异，并探讨了认知对运动功能的重要性。
本研究纳入了正常对照组（NC）、轻度认知障碍（MCI）或轻度痴呆（MD）个体。所有参与者都接受了全面评估，包括认知功能、运动功能、行走时的PFC活动以及跌倒恐惧。认知功能评估包括一般认知、注意力、执行功能、记忆和视觉空间能力。运动功能评估包括定时起立行走（TUG）测试、单步行走（SW）和认知双任务行走（CDW）。
与MCI和NC个体相比，MD个体的SW、CDW和TUG表现更差。MCI和NC之间的这些步态和平衡表现没有显著差异。运动功能均与一般认知、注意力、执行功能、记忆和视觉空间能力相关。通过连线测验A（TMT-A）测量的注意力能力是TUG和步态速度的最佳预测指标。三组之间的PFC活动没有显著差异。然而，与SW相比，MCI个体在CDW期间PFC激活更多（=0.000），其他两组未显示出这种情况。
与NC和MCI相比，MD表现出更差的运动功能。MCI个体在CDW期间更大的PFC活动可能被视为维持步态表现的一种代偿策略。运动功能与认知功能相关，在本研究中，TMT A是老年人步态相关表现的最佳预测指标。
