基于计时起立行走双重任务测试言语和运动结果预测向痴呆障碍的转化：一项基于记忆门诊的五年前瞻性研究。

Prediction of conversion to dementia disorders based on timed up and go dual-task test verbal and motor outcomes: a five-year prospective memory-clinic-based study.

机构信息

School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden.

Department of Public Health and Caring Sciences, Geriatrics, Uppsala Universit, y, Box 564, 52 37, UPPSALA, Sweden.

出版信息

BMC Geriatr. 2023 Sep 2;23(1):535. doi: 10.1186/s12877-023-04262-w.

DOI:10.1186/s12877-023-04262-w

PMID:37660032

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10475186/

Abstract

BACKGROUND

While assessment tools can increase the detection of cognitive impairment, there is currently insufficient evidence regarding clinical outcomes based on screening for cognitive impairment in older adults.

METHODS

The study purpose was to investigate whether Timed Up and Go dual-task test (TUGdt) results, based on TUG combined with two different verbal tasks (name different animals, TUGdt-NA, and recite months in reverse order, TUGdt-MB), predicted dementia incidence over a period of five years among patients (N = 186, mean = 70.7 years; 45.7% female) diagnosed with Subjective Cognitive Impairment (SCI) and Mild Cognitive Impairment (MCI) following assessment at two memory clinics. Associations between TUG parameters and dementia incidence were examined in Cox regression models.

RESULTS

During follow-up time (median (range) 3.7 (0.1-6.1) years) 98 participants converted to dementia. Novel findings indicated that the TUGdt parameter words/time, after adjustment for age, gender, and education, can be used for the prediction of conversion to dementia in participants with SCI or MCI over a period of five years. Among the TUG-related parameters investigated, words/time showed the best predictive capacity, while time scores of TUG and TUGdt as well as TUGdt cost did not produce significant predictive results. Results further showed that the step parameter step length during TUGdt predicts conversion to dementia before adjustment for age, gender, and education. Optimal TUGdt cutoffs for predicting dementia at 2- and 4-year follow-up based on words/time were calculated. The sensitivity of the TUGdt cutoffs was high at 2-year follow-up: TUGdt-NA words/time, 0.79; TUGdt-MB words/time, 0.71; reducing respectively to 0.64 and 0.65 at 4-year follow-up.

CONCLUSIONS

TUGdt words/time parameters have potential as cost-efficient tools for conversion-to-dementia risk assessment, useful for research and clinical purposes. These parameters may be able to bridge the gap of insufficient evidence for such clinical outcomes.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05893524: https://www.

CLINICALTRIALS

gov/study/NCT05893524?id=NCT05893524&rank=1 .

摘要

背景

虽然评估工具可以提高认知障碍的检出率，但目前尚无足够的证据表明，对老年人进行认知障碍筛查可以改善临床结局。

方法

本研究旨在探讨在两个记忆诊所进行评估后，被诊断为主观认知障碍（SCI）和轻度认知障碍（MCI）的患者（N=186，平均年龄=70.7 岁；45.7%为女性），在 5 年内，基于计时起立行走测试（TUG）与两个不同的口头任务（说出不同的动物，TUGdt-NA 和倒背月份，TUGdt-MB）结合的 TUG 双重任务测试（TUGdt）结果是否能预测痴呆症的发病率。使用 Cox 回归模型来检验 TUG 参数与痴呆症发病率之间的关系。

结果

在随访期间（中位数（范围）3.7（0.1-6.1）年），98 名参与者转化为痴呆症。新的研究结果表明，在调整年龄、性别和教育程度后，TUGdt 参数单词/时间可以用于预测 SCI 或 MCI 患者在 5 年内向痴呆症的转化。在所研究的 TUG 相关参数中，单词/时间显示出最佳的预测能力，而 TUG 和 TUGdt 的时间评分以及 TUGdt 成本并未产生显著的预测结果。结果进一步表明，在未调整年龄、性别和教育程度的情况下，TUGdt 测试中的步长参数步长可以预测向痴呆症的转化。根据单词/时间计算了在 2 年和 4 年随访时预测痴呆症的最佳 TUGdt 截断值。TUGdt 截断值的敏感性在 2 年随访时较高：TUGdt-NA 单词/时间为 0.79；TUGdt-MB 单词/时间为 0.71；分别降低到 0.64 和 0.65 在 4 年随访时。