Program in Occupational Therapy, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
J Gerontol A Biol Sci Med Sci. 2024 Jul 1;79(7). doi: 10.1093/gerona/glae091.
It is unknown whether older adults with preclinical Alzheimer disease (AD) experience changes in postural sway compared with those without preclinical AD. The purpose of this study was to understand the effect of dual tasking on standing balance, or postural sway, for people with and without preclinical AD.
A cross-sectional analysis of baseline data from a longitudinal cohort study. Participants were cognitively normal older adults with and without preclinical AD. Postural sway (path length) was tested using a force plate under standard and dual task balance conditions. Dual task cost (DTC) was calculated to examine performance change in balance conditions. Logistic regression models were used to predict preclinical AD status as a function of DTC.
203 participants (65 preclinical AD+) were included. DTC for path length was significantly greater for participants with preclinical AD (DTC path length mean difference 19.8, 95% CI 2.6-37.0, t(201) = 2.29, p = .024). Greater DTC was significantly associated with increased odds of having preclinical AD (adjusted odds ratio for a 20-unit increase in DTC 1.16, 95% CI 1.02-1.32).
Older adults with preclinical AD are more likely to demonstrate significantly greater DTC in postural sway than those without preclinical AD. Dual tasking should be integrated into balance and fall risk assessments and may inform early detection of preclinical AD.
目前尚不清楚是否患有临床前阿尔茨海默病（AD）的老年人在姿势摆动方面与没有临床前 AD 的老年人相比是否会发生变化。本研究的目的是了解双任务对有和没有临床前 AD 的人的站立平衡或姿势摆动的影响。
对一项纵向队列研究的基线数据进行横断面分析。参与者为认知正常的老年人群，分为有和没有临床前 AD 两组。使用力板在标准和双任务平衡条件下测试姿势摆动（路径长度）。计算双任务成本（DTC）以检查平衡条件下的性能变化。使用逻辑回归模型预测 DTC 作为临床前 AD 状态的函数。
共有 203 名参与者（65 名临床前 AD+）被纳入研究。临床前 AD 组的路径长度 DTC 明显更大（临床前 AD 组 DTC 路径长度平均差异为 19.8，95%置信区间为 2.6-37.0，t（201）=2.29，p=0.024）。较大的 DTC 与临床前 AD 的发生几率显著增加相关（DTC 增加 20 个单位时的调整优势比为 1.16，95%置信区间为 1.02-1.32）。
与没有临床前 AD 的老年人相比，患有临床前 AD 的老年人在姿势摆动时更有可能出现明显更大的 DTC。双任务应纳入平衡和跌倒风险评估中，可能有助于早期发现临床前 AD。
