Thompson Atalie C, Mansfield Tyler, Johnson Eileen, Cawthon Peggy M, Strotmeyer Elsa S, Williamson Jeff D, Cummings Steve, Mau Theresa, Kritchevsky Stephen B
Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
J Gerontol A Biol Sci Med Sci. 2025 May 5;80(6). doi: 10.1093/gerona/glaf065.
Sensory and cognitive function can impact physical performance, but the relationship of multiple sensory impairments (SIs) with mobility in older adults is not well understood. We hypothesized that severity and number of SIs would be associated with worse timed physical mobility performance, and that cognitive processing speed would mediate the association.
Participants (N = 832) were older adults (mean age 76.3 ± 5.0 years; 59.4% women; 84.2% non-Hispanic White) who completed tests of physical performance, cognitive function, and multiple sensory domains. Separate linear regression models examined the association of SI with 400-m walk, expanded Short Physical Performance Battery (eSPPB), 4-square step test (FSST), and stair climb test. Cognitive measures of executive function/processing speed (Digit Symbol Coding [DSC] and Trail Making Test [Trails] B) were tested as potential mediators of the relationship between SI and physical performance.
Each 1-point decrement in SI scale was associated with slower 400-m walking speed (β = -0.01 m/s, p = .03), lower eSPPB score (β = -0.05 points, p < .001), and longer FSST time (β = 0.20 seconds, p = .01), but there was no association with stair climb time. Using a causal mediation approach with DSC and Trails B as potential mediators, 47.9% of the association of SI with 400-m walk, 43.8% of the association of SI with eSPPB, and 56.7% of the association of multiple SI with FSST were mediated.
Greater SIs were associated with worse physical performance in older adults, and the association was partially mediated by measures of cognitive processing speed and executive function. Future studies should investigate the temporal relationship between SIs, cognitive function, and physical function.
感觉和认知功能会影响身体机能，但多种感觉障碍（SI）与老年人活动能力之间的关系尚未完全明确。我们假设，SI的严重程度和数量与较差的定时身体活动能力相关，且认知处理速度会介导这种关联。
参与者（N = 832）为老年人（平均年龄76.3±5.0岁；59.4%为女性；84.2%为非西班牙裔白人），他们完成了身体机能、认知功能和多个感觉领域的测试。分别采用线性回归模型研究SI与400米步行、扩展简短身体机能测试（eSPPB）、四方步测试（FSST）和爬楼梯测试之间的关联。将执行功能/处理速度的认知指标（数字符号编码[DSC]和连线测验[Trails]B）作为SI与身体机能关系的潜在中介因素进行测试。
SI量表每降低1分，与400米步行速度减慢（β = -0.01米/秒，p = 0.03）、eSPPB得分降低（β = -0.05分，p < 0.001）以及FSST时间延长（β = 0.20秒，p = 0.01）相关，但与爬楼梯时间无关。采用以DSC和Trails B作为潜在中介因素的因果中介方法，SI与400米步行关联的47.9%、SI与eSPPB关联的43.8%以及多种SI与FSST关联的56.7%得到了介导。
老年人中更严重的SI与更差的身体机能相关，且这种关联部分由认知处理速度和执行功能指标介导。未来研究应调查SI、认知功能和身体功能之间的时间关系。
