白质高信号与无痴呆症老年人的步态速度减慢有关。
White Matter Hyperintensities Are Associated with Slower Gait Speed in Older Adults without Dementia.
作者信息
Vazquez Juan P, Verghese Joe, Barzilai Nir, Milman Sofiya, Blumen Helena M
机构信息
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,
Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA,
出版信息
Neurodegener Dis. 2024;24(3-4):97-105. doi: 10.1159/000538944. Epub 2024 Jul 18.
INTRODUCTION
Slow gait speed is associated with poor health outcomes in aging, but the relationship between cerebral small vessel disease (CSVD) pathologies and gait speed in aging is not well understood. We investigated the relationships between CSVD imaging markers and gait speed during simple (normal pace walking [NPW]) and complex (walking while talking [WWT]) as both measures are associated with shared health outcomes such as falls, frailty, disability, mortality, and dementia.
METHODS
A total of 113 Ashkenazi Jewish adults over 65 (M age = 78.6 ± 6.3 years, 45.8% women) and without dementia were examined. Established rating systems were used to quantify white matter hyperintensities (WMHs) and lacunes of presumed vascular origin from fluid-attenuated inversion recovery (FLAIR) images. Linear regression models adjusted for age, sex, global health, and total intracranial volume were used to examine associations between CSVD markers and gait speed during NPW and WWT. Student t tests were used to contrast gait speed in those with "confluent-diffuse" WMH and those with "mild or no" WMH.
RESULTS
The number of WMH in the basal ganglia (β = -3.274 cm/s p = 0.047) and temporal lobes (β = -3.113 cm/s p = 0.048) were associated with slower NPW speed in adjusted models. Participants with higher CSVD burden (confluent-diffuse pattern) in the frontal lobe (94.65 cm/s vs. 105.21 cm/s, p = 0.018) and globally (98.98 cm/s vs. 107.24 cm/s, p = 0.028) also had lower NPW speed. WMHs were not associated with WWT speeds. Lacunes were not associated with NPW or WWT speed.
CONCLUSION
Adjusted models found higher CSVD burden as measured by the presence of WMH in the basal ganglia and temporal lobes were associated with slower normal pace gait speed in older adults, but not with complex walking speeds. Participants with confluent-diffuse WMHs in the frontal lobes were found to have slower average normal gait speed. Further studies are needed to establish the temporality of WMH and gait speed decline as well as mechanistic links between the two.
INTRODUCTION
Slow gait speed is associated with poor health outcomes in aging, but the relationship between cerebral small vessel disease (CSVD) pathologies and gait speed in aging is not well understood. We investigated the relationships between CSVD imaging markers and gait speed during simple (normal pace walking [NPW]) and complex (walking while talking [WWT]) as both measures are associated with shared health outcomes such as falls, frailty, disability, mortality, and dementia.
METHODS
A total of 113 Ashkenazi Jewish adults over 65 (M age = 78.6 ± 6.3 years, 45.8% women) and without dementia were examined. Established rating systems were used to quantify white matter hyperintensities (WMHs) and lacunes of presumed vascular origin from fluid-attenuated inversion recovery (FLAIR) images. Linear regression models adjusted for age, sex, global health, and total intracranial volume were used to examine associations between CSVD markers and gait speed during NPW and WWT. Student t tests were used to contrast gait speed in those with "confluent-diffuse" WMH and those with "mild or no" WMH.
RESULTS
The number of WMH in the basal ganglia (β = -3.274 cm/s p = 0.047) and temporal lobes (β = -3.113 cm/s p = 0.048) were associated with slower NPW speed in adjusted models. Participants with higher CSVD burden (confluent-diffuse pattern) in the frontal lobe (94.65 cm/s vs. 105.21 cm/s, p = 0.018) and globally (98.98 cm/s vs. 107.24 cm/s, p = 0.028) also had lower NPW speed. WMHs were not associated with WWT speeds. Lacunes were not associated with NPW or WWT speed.
CONCLUSION
Adjusted models found higher CSVD burden as measured by the presence of WMH in the basal ganglia and temporal lobes were associated with slower normal pace gait speed in older adults, but not with complex walking speeds. Participants with confluent-diffuse WMHs in the frontal lobes were found to have slower average normal gait speed. Further studies are needed to establish the temporality of WMH and gait speed decline as well as mechanistic links between the two.
引言
步态速度缓慢与衰老过程中的不良健康结局相关，但脑小血管疾病（CSVD）病理与衰老过程中步态速度之间的关系尚未完全明确。我们研究了CSVD成像标志物与简单（正常步速行走[NPW]）和复杂（边走边说[WWT]）步态速度之间的关系，因为这两种测量方式都与跌倒、虚弱、残疾、死亡率和痴呆等共同的健康结局相关。
方法
共检查了113名65岁以上的阿什肯纳兹犹太成年人（平均年龄=78.6±6.3岁，45.8%为女性），且这些人无痴呆症。使用既定的评分系统从液体衰减反转恢复（FLAIR）图像中量化白质高信号（WMH）和假定血管源性腔隙。采用调整了年龄、性别、整体健康状况和总颅内体积的线性回归模型，来研究CSVD标志物与NPW和WWT期间步态速度之间的关联。使用学生t检验对比“融合性-弥漫性”WMH患者和“轻度或无”WMH患者的步态速度。
结果
在调整后的模型中，基底节区（β=-3.274cm/s，p=0.047）和颞叶（β=-（此处原文重复内容，翻译相同）3.113cm/s，p=0.048）的WMH数量与较慢的NPW速度相关。额叶（94.65cm/s对105.21cm/s，p=0.018）和整体（98.98cm/s对107.24cm/s，p=0.028）CSVD负担较高（融合性-弥漫性模式）的参与者NPW速度也较低。WMH与WWT速度无关。腔隙与NPW或WWT速度无关。
结论
调整后的模型发现，以基底节区和颞叶存在WMH衡量的较高CSVD负担与老年人正常步速步态速度较慢相关，但与复杂行走速度无关。发现额叶有融合性-弥漫性WMH的参与者平均正常步态速度较慢。需要进一步研究来确定WMH与步态速度下降的时间关系以及两者之间的机制联系。
引言
步态速度缓慢与衰老过程中的不良健康结局相关，但脑小血管疾病（CSVD）病理与衰老过程中步态速度之间的关系尚未完全明确。我们研究了CSVD成像标志物与简单（正常步速行走[NPW]）和复杂（边走边说[WWT]）步态速度之间的关系，因为这两种测量方式都与跌倒、虚弱、残疾、死亡率和痴呆等共同的健康结局相关。
方法
共检查了113名65岁以上的阿什肯纳兹犹太成年人（平均年龄=78.6±6.3岁，45.8%为女性），且这些人无痴呆症。使用既定的评分系统从液体衰减反转恢复（FLAIR）图像中量化白质高信号（WMH）和假定血管源性腔隙。采用调整了年龄、性别、整体健康状况和总颅内体积的线性回归模型，来研究CSVD标志物与NPW和WWT期间步态速度之间的关联。使用学生t检验对比“融合性-弥漫性”WMH患者和“轻度或无”WMH患者的步态速度。
结果
在调整后的模型中，基底节区（β=-3.274cm/s，p=0.047）和颞叶（β=-3.113cm/s，p=0.048）的WMH数量与较慢的NPW速度相关。额叶（94.65cm/s对105.21cm/s，p=0.018）和整体（98.98cm/s对107.24cm/s，p=0.028）CSVD负担较高（融合性-弥漫性模式）的参与者NPW速度也较低。WMH与WWT速度无关。腔隙与NPW或WWT速度无关。
结论
调整后的模型发现，以基底节区和颞叶存在WMH衡量的较高CSVD负担与老年人正常步速步态速度较慢相关，但与复杂行走速度无关。发现额叶有融合性-弥漫性WMH的参与者平均正常步态速度较慢。需要进一步研究来确定WMH与步态速度下降的时间关系以及两者之间的机制联系。
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