Grill Eva, Zwergal Andreas, Saur Dorothee, Klingbeil Julian, Fricke Christopher, Schöberl Florian, Felfela Karim, Zülke Andrea, Riedel-Heller Steffi, Classen Joseph
Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig-Maximilians Universität Munich, Munich, Germany.
German Center for Vertigo and Balance Disorders, LMU University Hospital, Munich, Germany.
Front Neurol. 2024 Dec 11;15:1452150. doi: 10.3389/fneur.2024.1452150. eCollection 2024.
Modifiable risk factors play an important role in preventing dementia and reducing its progression. Regular physical activity already in midlife, which relies on intact multisensory balance control, can help to decrease the risk of dementia. However, our understanding of the relationship between postural balance and cognitive functions remains limited. The objective of our study was to investigate the association of postural balance during different sensory conditions with specific cognitive domains in older adults.
Participants were from the population-based prospective "Leipzig Research Center for Civilization Diseases" (LIFE-Adult) cohort in Leipzig, Germany. Executive, memory and processing speed functions were tested by the Consortium to Establish a Registry for Alzheimer's disease (CERAD) plus battery. Assessment of visuospatial abilities was based on the short form of the Judgment of Line Orientation Test (JLO). Postural sway was recorded on a force plate with eyes open and closed. Romberg's ratios were calculated for sway path and sway area as a proxy for balance without visual control and tested in generalized linear regression models with the summary scores of executive function, memory, processing speed and visuospatial function as dependent variables. All models were adjusted for sex, age, ApoE status, socioeconomic status, anamnestic stroke, and diabetes.
In total, we analyzed 460 participants with a mean age of 68.6 years, range 60 to 80, 47.6% female. A higher Romberg's ratio for sway area was a significant indicator for impaired visuospatial abilities as measured by the dichotomized JLO (Odds Ratio = 1.42, 95% confidence interval 1.07 to 1.88). Romberg's ratios were not significantly associated with executive functions, procedural speed or memory functions.
It may be worthwhile to examine in the future whether inclusion of balance testing enhances the value of screening programs for cognitive impairment. Inversely, it may be appropriate to apply routine cognitive tests when balance problems are detected in older patients.
可改变的风险因素在预防痴呆症及其病情进展方面发挥着重要作用。中年时期就开始的规律体育活动依赖于完整的多感官平衡控制，有助于降低患痴呆症的风险。然而，我们对姿势平衡与认知功能之间关系的理解仍然有限。我们研究的目的是调查老年人在不同感觉条件下的姿势平衡与特定认知领域之间的关联。
参与者来自德国莱比锡基于人群的前瞻性“莱比锡文明病研究中心”（LIFE-成人）队列。执行功能、记忆和处理速度功能通过阿尔茨海默病注册协会（CERAD）加电池组进行测试。视觉空间能力评估基于线方向判断测试（JLO）的简短形式。在睁眼和闭眼状态下，在测力板上记录姿势摆动情况。计算闭眼与睁眼时摆动路径和摆动面积的罗姆伯格比率，作为无视觉控制时平衡的指标，并在广义线性回归模型中进行测试，将执行功能、记忆、处理速度和视觉空间功能的汇总分数作为因变量。所有模型均对性别、年龄、载脂蛋白E状态、社会经济地位、既往中风史和糖尿病进行了调整。
我们总共分析了460名参与者，平均年龄68.6岁（范围60至80岁），女性占47.6%。通过二分法JLO测量，较高的闭眼与睁眼时摆动面积的罗姆伯格比率是视觉空间能力受损的显著指标（优势比 = 1.42，95%置信区间1.07至1.88）。罗姆伯格比率与执行功能、程序速度或记忆功能无显著关联。
未来研究纳入平衡测试是否能提高认知障碍筛查项目的价值可能是值得的。相反，当在老年患者中检测到平衡问题时，应用常规认知测试可能是合适的。
