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跌倒、步态与认知:主观记忆障碍的老年人跌倒相关危险因素

Stumbles, Gait, and Cognition: Risk Factors Associated with Falls in Older Adults with Subjective Memory Complaints.

作者信息

Delgado Isabella, Camacho Miguel Angello, Pugliese Isabella, Clavijo Hugo Juan Camilo, Moreno Mabel, Muñoz Ospina Beatriz, Orozco Jorge

机构信息

Centro de Investigaciones Clínicas, Fundación Valle del Lili, Carrera 98 No. 18-49, Cali 760032, Colombia.

Faculty of Health Sciences, Universidad Icesi, Calle 18 No. 122-135, Cali 760031, Colombia.

出版信息

Int J Environ Res Public Health. 2024 Dec 17;21(12):1683. doi: 10.3390/ijerph21121683.

Abstract

Falls are a public health problem, impacting quality of life, independence, and health costs. Subjective memory complaints (SMCs) and mild cognitive impairment (MCI) increase with age and may coexist. The risk of falls coinciding with SMCs is less understood. This study explored the risk factors associated with falls in adults with SMCs or MCI. A case-control study in adults over 50 was conducted. All participants underwent a neuropsychological assessment and a Timed Up and Go (TUG) test for gait analysis. Logistic regression calculated OR and values, adjusting for demographic, clinical, cognitive, and gait variables. There was a total of 64 patients (47.06%) and 72 controls (52.94%). Fallers were older (70.76 ± 7.31) and had hypertension (29.63%), a history of stumbling (13.97%), slow TUG test performance (19.12%), and an asymmetric arm swing (19.85%). Fallers had lower verbal fluency ( = 0.043) and impairment on the Rey-Osterrieth figure copy ( = 0.047). Highest risk factors included female sex (OR 3.55, = 0.006), older age (OR= 1.08, = 0.006), hypertension (OR 3.33, = 0.005), and stumbles (OR 5.65, = 0.002). This study reconsiders clinical fall risk assessments in older adults with SMCs. Visuo-constructional abilities and executive dysfunction should be followed over time. Female sex, hypertension, and stumbles are risk factors. Integrated cognitive and motor assessments are crucial for detecting and proposing interventions for fall prevention in this population.

摘要

跌倒属于公共卫生问题,会影响生活质量、独立性和医疗成本。主观记忆抱怨(SMC)和轻度认知障碍(MCI)会随着年龄增长而增加,且可能同时存在。跌倒与SMC同时出现的风险鲜为人知。本研究探讨了患有SMC或MCI的成年人跌倒的相关危险因素。对50岁以上的成年人进行了一项病例对照研究。所有参与者均接受了神经心理学评估和计时起立行走(TUG)测试以进行步态分析。逻辑回归计算了比值比(OR)和P值,并对人口统计学、临床、认知和步态变量进行了调整。共有64例患者(47.06%)和72例对照者(52.94%)。跌倒者年龄较大(70.76±7.31),患有高血压(29.63%),有绊倒史(13.97%),TUG测试表现缓慢(19.12%),以及手臂摆动不对称(19.85%)。跌倒者的语言流畅性较低(P = 0.043),在复制雷-奥斯特里思复杂图形时有损伤(P = 0.047)。最高风险因素包括女性(OR 3.55,P = 0.006)、年龄较大(OR = 1.08,P = 0.006)、高血压(OR 3.33,P = 0.005)和绊倒(OR 5.65,P = 0.002)。本研究重新审视了患有SMC的老年人的临床跌倒风险评估。视觉构建能力和执行功能障碍应随时间进行跟踪。女性、高血压和绊倒都是风险因素。综合认知和运动评估对于检测和提出该人群预防跌倒的干预措施至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88b7/11675928/cea056657e83/ijerph-21-01683-g001.jpg

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