Lin Sang-I, Chen Pei-Hao, Liao Ying-Yi, Huang Jhih-Yu, Cheng Fang-Yu
Institute of Long-term Care, MacKay Medical College, New Taipei City, Taiwan.
Department of Medicine, MacKay Medical College, New Taipei City, Taipei, Taiwan.
J Geriatr Phys Ther. 2025;48(2):88-97. doi: 10.1519/JPT.0000000000000455. Epub 2025 Apr 9.
Motoric cognitive risk syndrome (MCR) is a predementia syndrome and is a strong predictor of Alzheimer's disease (AD). Functional mobility, such as balance, sit-stand transitions, and turning, has not been clearly investigated in this population. This study aimed to compare functional mobility among older adults with normal cognition (NC), MCR, and mild AD. Cognitive-motor interactions were also investigated in all the groups.
This cross-sectional study included 91 older adults, including 36 with NC, 32 with MCR, and 23 with mild AD. A battery of neuropsychology tests encompassing several domains, including general cognition, executive function, attention, episodic memory, visuospatial performance, and language, was administered, and functional mobility tasks, including the Short Physical Performance Battery (SPPB) and the Timed Up and Go Test (TUG), were also carried out. Differences between groups were analyzed with MANCOVAs (post hoc Bonferroni correction). Partial correlation analysis adjusted for age and education levels was used to examine correlations between functional mobility and cognitive function in each group. Canonical correlation analyses were used to determine the extent of the relationship between a set of cognitive variables (executive function, attention, and visuospatial performance) and a set of functional mobility variables (the SPPB and TUG) in the NC, MCR, and mild AD groups.
The SPPB and TUG performance of the MCR and mild AD groups was significantly worse than that of the NC group. Visuospatial performance and depression were significantly correlated with functional mobility in the MCR group, while depression was the only specific cognitive aspect associated with functional mobility in the mild AD group. Canonical analysis demonstrated a significant relationship between cognition and mobility, explaining approximately 28.4% of the variance, in the NC group. However, the other two groups showed no significant correlation between cognition and mobility.
In addition to slow gait, deficits in sit-stand transitions and turning were also observed in the MCR and mild AD groups. We also found that motor-cognitive interactions may differ according to the level of cognitive impairment. Future studies should comprehensively assess functional mobility for different cognitive impairment populations.
运动认知风险综合征(MCR)是一种痴呆前综合征,是阿尔茨海默病(AD)的有力预测指标。在这一人群中,诸如平衡、坐立转换和转身等功能移动能力尚未得到明确研究。本研究旨在比较认知正常(NC)、患有MCR和轻度AD的老年人的功能移动能力。还对所有组的认知 - 运动相互作用进行了研究。
这项横断面研究纳入了91名老年人,其中36名认知正常,32名患有MCR,23名患有轻度AD。进行了一系列涵盖多个领域的神经心理学测试,包括一般认知、执行功能、注意力、情景记忆、视觉空间能力和语言能力,并开展了功能移动任务,包括简短体能测试电池(SPPB)和定时起立行走测试(TUG)。使用多变量协方差分析(事后邦费罗尼校正)分析组间差异。采用经年龄和教育水平调整的偏相关分析来检验每组中功能移动能力与认知功能之间的相关性。使用典型相关分析来确定NC组、MCR组和轻度AD组中一组认知变量(执行功能、注意力和视觉空间能力)与一组功能移动变量(SPPB和TUG)之间的关系程度。
MCR组和轻度AD组的SPPB和TUG表现明显差于NC组。在MCR组中,视觉空间能力和抑郁与功能移动能力显著相关,而在轻度AD组中,抑郁是与功能移动能力相关的唯一特定认知方面。典型分析表明,在NC组中,认知与移动能力之间存在显著关系,解释了约28.4%的方差。然而,其他两组在认知与移动能力之间未显示出显著相关性。
除了步态缓慢外,在MCR组和轻度AD组中还观察到坐立转换和转身方面的缺陷。我们还发现,运动 -认知相互作用可能因认知障碍程度而异。未来的研究应全面评估不同认知障碍人群的功能移动能力。