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日本社区居住老年人的主观认知衰退与衰弱轨迹及影响因素:一项纵向研究

Subjective Cognitive Decline and Frailty Trajectories and Influencing Factors in Japanese Community-Dwelling Older Adults: A Longitudinal Study.

作者信息

Bae Seongryu, Shimada Hiroyuki, Lee Sangyoon, Makino Keitaro, Chiba Ippei, Katayama Osamu, Harada Kenji, Park Hyuntae, Toba Kenji

机构信息

Department of Health Care and Science, Dong-A University, 37 Nakdong-daero 550, Saha-gu, Busan 49315, Republic of Korea.

Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu 474-8511, Aichi, Japan.

出版信息

J Clin Med. 2023 Sep 6;12(18):5803. doi: 10.3390/jcm12185803.

Abstract

We studied frailty and subjective cognitive decline (SCD) trajectories in older Japanese adults and evaluated the influence of various factors on these trajectories. We analyzed data from 1157 non-demented adults aged 70 and above from 2013 to 2019. Frailty was assessed using the self-administered Kihon Checklist (KCL), a Japanese frailty index. SCD was evaluated using the questionnaire of the Subjective Memory Complaints scale. Through group-based joint trajectory models, we discerned three frailty trajectories: non-progressive ( = 775), moderate progressive ( = 312), and rapid progressive ( = 70); and three SCD trajectories: non-progressive ( = 302), moderate progressive ( = 625), and rapid progressive ( = 230). Individuals in the rapid progressive SCD trajectory had a 32.2% probability of also being in the rapid progressive frailty trajectory. In contrast, those in the non-progressive SCD trajectory had zero probability of being in the rapid progressive frailty trajectory. Both the rapid progressive frailty and SCD groups combined had a higher incidence of depressive symptoms and slow gait speed. Our results have found that frailty and SCD share a similar trajectory in Japanese older adults. Additionally, rapid progressive frailty and SCD were associated with the highest risk of depressive symptoms and slow gait speed. Thus, interventions targeting both frailty and cognitive decline should prioritize mental health enhancement and gait speed improvement.

摘要

我们研究了日本老年人群体中的衰弱和主观认知衰退(SCD)轨迹,并评估了各种因素对这些轨迹的影响。我们分析了2013年至2019年期间1157名70岁及以上非痴呆成年人的数据。使用日本衰弱指数——自填式基本健康检查表(KCL)评估衰弱情况。使用主观记忆抱怨量表问卷评估SCD。通过基于群体的联合轨迹模型,我们识别出三种衰弱轨迹:非进展型(n = 775)、中度进展型(n = 312)和快速进展型(n = 70);以及三种SCD轨迹:非进展型(n = 302)、中度进展型(n = 625)和快速进展型(n = 230)。处于快速进展型SCD轨迹的个体有32.2%的概率也处于快速进展型衰弱轨迹。相比之下,处于非进展型SCD轨迹的个体处于快速进展型衰弱轨迹的概率为零。快速进展型衰弱组和SCD组合并后抑郁症状发生率更高,步态速度更慢。我们的研究结果发现,在日本老年人中,衰弱和SCD具有相似的轨迹。此外,快速进展型衰弱和SCD与抑郁症状和步态速度慢的最高风险相关。因此,针对衰弱和认知衰退的干预措施应优先考虑改善心理健康和提高步态速度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/988f/10532373/63da3de14fb1/jcm-12-05803-g001.jpg

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