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社区居住的老年人5年随访期间内在能力、血浆p-tau181与认知功能之间的关联:MAPT研究的二次分析

Associations between intrinsic capacity, plasma p-tau181 and cognitive function over a 5-year follow-up among community-dwelling older adults: a secondary analysis of the MAPT Study.

作者信息

Giudici Kelly Virecoulon, de Souto Barreto Philipe, Cantet Christelle, Zetterberg Henrik, Blennow Kaj, Vellas Bruno

机构信息

IHU HealthAge, Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.

IHU HealthAge, Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; CERPOP UMR1295, University of Toulouse III, Inserm UPS, Toulouse, France.

出版信息

J Frailty Aging. 2025 Aug;14(4):100064. doi: 10.1016/j.tjfa.2025.100064. Epub 2025 Jul 1.

Abstract

BACKGROUND

Intrinsic capacity (IC) is a recent key concept proposed by the World Health Organization (WHO) based on aspects of functional ability (both physical and mental) rather than the presence or absence of diseases, with a potential to predict several health outcomes.

OBJECTIVE

To explore associations between IC and cognitive function (prospectively), and between IC and plasma p-tau181 (cross-sectionally and prospectively) among community-dwelling older adults.

METHODS

Observational study with 491 subjects ≥70 years (67.4 % female, mean 75.3 years, SD=4.4), participants from the Multidomain Alzheimer Preventive Trial (MAPT). IC domains (locomotion, cognition, psychological, vitality) were combined into a 0-100 score. Alternative classification was based on the number of domains' abnormalities. Plasma p-tau181 was measured at baseline and 36 months of follow-up. A composite cognitive score (CCS) based on four tests was determined at baseline, 6, 12, 24, 36, 48 and 60 months.

RESULTS

Inverse cross-sectional associations were observed between baseline IC score and p-tau181 (unadjusted model: β=-0.08, 95 %CI -0.13 to -0.03; p = 0.0025). A significant mean difference in p-tau181 3-year changes was observed between participants with low and normal IC (based on IC score) (adjusted model: 1.71, 95 %CI 0.01 to 3.40; p = 0.0483). Prospective 5-year associations between IC and CCS were only observed in unadjusted analysis according to the alternative IC classification (-0.21, 95 %CI -0.38 to -0.04; p = 0.0156).

CONCLUSION

IC was associated with plasma p-tau181 and cognitive function, but findings varied according to the method of IC classification. Further research may help settle the role of IC as a predictor of neurodegenerative diseases such as AD. In this regard, multidomain interventions have potential to protect IC over the aging process and prevent cognitive impairment, and should also be encouraged.

摘要

背景

内在能力(IC)是世界卫生组织(WHO)最近提出的一个关键概念,它基于功能能力(身体和心理方面)而非疾病的有无,具有预测多种健康结果的潜力。

目的

探讨社区居住的老年人中IC与认知功能(前瞻性)以及IC与血浆p-tau181之间的关联(横断面和前瞻性)。

方法

对491名年龄≥70岁的受试者(67.4%为女性,平均年龄75.3岁,标准差=4.4)进行观察性研究,这些参与者来自多领域阿尔茨海默病预防试验(MAPT)。IC领域(运动、认知、心理、活力)被合并为一个0至100分的分数。另一种分类是基于领域异常的数量。在基线和随访36个月时测量血浆p-tau181。在基线、6、12、24、36、48和60个月时,根据四项测试确定综合认知评分(CCS)。

结果

在基线IC评分与p-tau181之间观察到反向横断面关联(未调整模型:β=-0.08,95%置信区间-0.13至-0.03;p = 0.0025)。在IC低和正常的参与者之间(基于IC评分),观察到p-tau181 3年变化的显著平均差异(调整模型:1.71,95%置信区间0.01至3.40;p = 0.0483)。根据IC的另一种分类,仅在未调整分析中观察到IC与CCS之间的前瞻性5年关联(-0.21,95%置信区间-0.38至-0.04;p = 0.0156)。

结论

IC与血浆p-tau181和认知功能相关,但结果因IC分类方法而异。进一步的研究可能有助于确定IC作为阿尔茨海默病等神经退行性疾病预测指标的作用。在这方面,多领域干预措施有可能在衰老过程中保护IC并预防认知障碍,也应受到鼓励。

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