College of Nursing, University of Tennessee, Knoxville, Tennessee, USA.
Department of Neurology, University of Minnesota, Minneapolis, Minnesota, USA.
J Adv Nurs. 2023 Dec;79(12):4815-4827. doi: 10.1111/jan.15768. Epub 2023 Jun 29.
To explore whether gait and/or balance disturbances are associated with the onset of Alzheimer's dementia (AD) among older adults with amnestic mild cognitive impairment (MCI).
This study employed a longitudinal retrospective cohort design.
We obtained data from the National Alzheimer's Coordinating Center's Uniform Data Set collected from 35 National Institute on Aging Alzheimer's Disease Research Centers between September 2005 and December 2021. The mean age of participants (n = 2692) was 74.5 years with women making up 47.2% of the sample. Risk of incident AD according to baseline gait and/or balance disturbances as measured using the Postural Instability and Gait Disturbance Score, a subscale of the Unified Parkinson's Disease Rating Scale Motor Score, was examined by the Cox proportional hazards regression models adjusting for baseline demographics, medical conditions and study sites. The mean follow-up duration was 4.0 years.
Among all the participants, the presence or the severity of gait and/or balance disturbances was associated with an increased risk of AD. The presence or the severity of gait and/or balance disturbances was associated with a higher risk of Alzheimer's dementia among the subgroups of female and male participants.
Gait and/or balance disturbances may increase the risk of developing AD, regardless of sex.
Gait and/or balance disturbances among community-dwelling older adults with amnestic MCI may need to be frequently assessed by nurses to identify potential risk factors for cognitive decline.
Given the secondary analysis, patients, service users, caregivers or members of the public were not directly involved in this study.
探讨步态和/或平衡障碍是否与遗忘型轻度认知障碍(MCI)老年人中阿尔茨海默病(AD)的发病有关。
本研究采用纵向回顾性队列设计。
我们从国家老龄化协会阿尔茨海默病协调中心的统一数据集获得了数据,该数据集来自 2005 年 9 月至 2021 年 12 月的 35 个国立老化研究所阿尔茨海默病研究中心。参与者的平均年龄(n=2692)为 74.5 岁,女性占样本的 47.2%。使用统一帕金森病评定量表运动评分的姿势不稳定和步态障碍评分(一个亚量表)来衡量基线时的步态和/或平衡障碍,通过 Cox 比例风险回归模型来评估其对 AD 发病风险的影响,该模型调整了基线人口统计学、医疗状况和研究地点。平均随访时间为 4.0 年。
在所有参与者中,步态和/或平衡障碍的存在或严重程度与 AD 发病风险增加有关。步态和/或平衡障碍的存在或严重程度与女性和男性参与者亚组的 AD 发病风险增加有关。
步态和/或平衡障碍可能会增加 AD 的发病风险,与性别无关。
社区居住的遗忘型 MCI 老年人的步态和/或平衡障碍可能需要由护士频繁评估,以识别认知能力下降的潜在危险因素。
鉴于这是二次分析,患者、服务使用者、护理人员或公众成员并未直接参与本研究。