Pieruccini-Faria Frederico, Hachinski Vladimir, Son Surim, Montero-Odasso Manuel
Gait and Brain Lab, St. Joseph's Health London Care, Parkwood Institute and Lawson Health Research Institute, Main Building Parkwood Institute, 550 Wellington Rd, Room A3-116, London, ON, N6C 0A7, Canada.
Schulich School of Medicine & Dentistry, Department of Medicine and Division of Geriatric Medicine, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.
Geroscience. 2025 Apr;47(2):1859-1871. doi: 10.1007/s11357-024-01372-0. Epub 2024 Oct 10.
This study investigates whether older adults diagnosed with the apathy, gait impairment, and executive dysfunction (AGED) triad, frequently associated with cerebrovascular disease and confounded with depression, have earlier dementia onset. We followed 322 community-dwelling older individuals (mean age 72.0 ± 6.4 years; 58.3% women) free of dementia at baseline for up to 9 years. The AGED triad was identified when gait slowness (< 1 m/s), apathy (assessed by Geriatric Depression Scale-3A with ≥ 2 items), and executive dysfunction (assessed by the 75th percentile of Trail Making Test-part B by age range) were simultaneously present. Incident dementia was diagnosed using the clinical dementia rating scale. Over the 9-year follow-up (mean 45.1 ± 28.6 months), 44 participants (13.6%) converted to dementia. Sixteen participants (5.0%) were diagnosed with AGED triad + and showed a significantly higher risk of earlier conversion to dementia compared with AGED triad- (hazard ratio = 5.08, 95%CI 2.16-11.97; p = 0.0001), as well as to those with only one AGED factor or fewer AGED factors. Hypertension and diabetes were 2 and 3 times more prevalent, respectively, in individuals with AGED triad + . These findings suggest that the AGED triad serves as a simplified and effective behavioral marker for accelerated progression to dementia.
本研究调查了被诊断患有冷漠、步态障碍和执行功能障碍（AGED）三联征的老年人是否更早出现痴呆症发作，该三联征常与脑血管疾病相关且易与抑郁症混淆。我们对322名社区居住的老年人（平均年龄72.0±6.4岁；58.3%为女性）进行了随访，这些老年人在基线时无痴呆症，随访时间长达9年。当同时出现步态迟缓（<1米/秒）、冷漠（通过老年抑郁量表-3A评估，≥2项）和执行功能障碍（通过按年龄范围划分的连线测验B部分的第75百分位数评估）时，确定为AGED三联征。使用临床痴呆评定量表诊断新发痴呆症。在9年的随访期内（平均45.1±28.6个月），44名参与者（13.6%）转变为痴呆症。16名参与者（5.0%）被诊断为AGED三联征阳性，与AGED三联征阴性者相比，其更早转变为痴呆症的风险显著更高（风险比=5.08，95%置信区间2.16-11.97；p=0.0001），与仅有一个AGED因素或更少AGED因素的人相比也是如此。高血压和糖尿病在AGED三联征阳性个体中的患病率分别是其他个体的2倍和3倍。这些发现表明，AGED三联征是痴呆症加速进展的一种简单有效的行为标志物。
