Executive Function, Dexterity, and Discharge Disposition in Older Intensive Care Unit Survivors.
Executive Function, Dexterity, and Discharge Disposition in Older Intensive Care Unit Survivors.
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DOI：
10.4037/ajcc2020132
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发表时间：
2020-11-01
期刊：
影响因子：
--
通讯作者：
Liang Z
中科院分区：
文献类型：
--
作者：
Elías MN;Munro CL;Liang Z
灵巧度是运动功能的一个组成部分。执行功能是认知的一个子领域，它可能会影响重症监护病房(ICU)出院后从危重疾病中恢复的老年人的灵活性。探讨ICU后早期执行功能(注意力和认知灵活性)与灵巧性(精细运动协调)之间的关系，并通过出院处置敏锐度来检验灵巧性。这项研究涉及30名老年人，他们在住院前功能独立，在ICU接受机械呼吸，并在24至48小时前出院。使用美国国立卫生研究院工具箱(NIHTB)机动电池9孔钉板灵活性测试(PDT)评估灵巧性；使用NIHTB认知电池侧翼抑制控制和注意力测试(FICAT)评估注意力；使用NIHTB认知电池维度变化卡分类测试(DCCST)评估认知灵活性。探索性回归被用来检验执行功能和灵巧度(完全校正的T分数)之间的关系。独立样本t检验用于比较出院的受试者和出院的受试者之间的灵活性。FICAT(β=0.375，P=0.03)和DCCST(β=0.698，P=.001)评分与PDT评分独立且正相关。此外，在出院的参与者中，PDT得分比出院的参与者更差(平均[SD]，26.71[6.14]比36.33[10.30]；T24=3.003；P=0.006)。执行功能差与灵巧性差相关；因此，灵巧性可能与ICU后认知障碍和功能下降有关。灵活性测试的表现可以确定虚弱的老年ICU幸存者有可能出现更差的出院结果。
Dexterity is a component of motor function. Executive function, a subdomain of cognition, may affect dexterity in older adults recovering from critical illness after discharge from an intensive care unit (ICU). To explore associations between executive function (attention and cognitive flexibility) and dexterity (fine motor coordination) in the early post-ICU period and examine dexterity by acuity of discharge disposition. The study involved 30 older adults who were functionally independent before hospitalization, underwent mechanical ventilation in the ICU, and had been discharged from the ICU 24 to 48 hours previously. Dexterity was evaluated with the National Institutes of Health Toolbox (NIHTB) Motor Battery 9-Hole Pegboard Dexterity Test (PDT); attention, with the NIHTB Cognition Battery Flanker Inhibitory Control and Attention Test (FICAT); and cognitive flexibility, with the NIHTB Cognition Battery Dimensional Change Card Sort Test (DCCST). Exploratory regression was used to examine associations between executive function and dexterity (fully corrected T scores). Independent-samples t tests were used to compare dexterity between participants discharged home and those discharged to a facility. FICAT (β = 0.375, P = .03) and DCCST (β = 0.698, P = .001) scores were independently and positively associated with PDT scores. Further, PDT scores were worse among participants discharged to a facility than among those discharged home (mean [SD], 26.71 [6.14] vs 36.33 [10.30]; t24 = 3.003; P = .006). Poor executive function is associated with worse dexterity; thus, dexterity may be a correlate of both post-ICU cognitive impairment and functional decline. Performance on dexterity tests could identify frail older ICU survivors at risk for worse discharge outcomes.
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DOI：
10.1056/nejmoa1301372
发表时间：
2013-10-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Pandharipande PP;Girard TD;Jackson JC;Morandi A;Thompson JL;Pun BT;Brummel NE;Hughes CG;Vasilevskis EE;Shintani AK;Moons KG;Geevarghese SK;Canonico A;Hopkins RO;Bernard GR;Dittus RS;Ely EW;BRAIN-ICU Study Investigators
通讯作者：
BRAIN-ICU Study Investigators
影响因子：
1.3
作者：
Hasemann, Wolfgang;Tolson, Debbie;Kressig, Reto W.
通讯作者：
Kressig, Reto W.
影响因子：
6.7
作者：
Pilotto, Alberto;Sancarlo, Daniele;Ferrucci, Luigi
通讯作者：
Ferrucci, Luigi
影响因子：
1.6
作者：
Bohannon, RW
通讯作者：
Bohannon, RW
影响因子：
2.7
作者：
Harrington, Mary Beth;Kraft, Malissa;Rudolph, James L.
通讯作者：
Rudolph, James L.