Assessing the Temporal Relationship Between Cognition and Gait: Slow Gait Predicts Cognitive Decline in the Mayo Clinic Study of Aging
Assessing the Temporal Relationship Between Cognition and Gait: Slow Gait Predicts Cognitive Decline in the Mayo Clinic Study of Aging
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DOI：
10.1093/gerona/gls256
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发表时间：
2013-08-01
影响因子：
5.1
通讯作者：
Petersen, Ronald C.
中科院分区：
文献类型：
--
作者：
Mielke, Michelle M.;Roberts, Rosebud O.;Petersen, Ronald C.
背景。步态速度与认知之间的关联已被报道；然而，关于认知正常个体中步态减慢和认知能力下降之间的时间关联的知识有限。方法。梅奥诊所老龄化研究是一项针对美国明尼苏达州奥姆斯特德县 70-89 岁居民的人口研究。该分析包括 1,478 名认知正常的参与者，他们每 15 个月接受一次护士访视、神经系统评估和神经心理学测试的评估。神经心理学小组使用九项测试来计算特定领域（记忆、语言、执行功能和视觉空间技能）和整体认知 z 分数。以正常配速评估 25 英尺（7.6 米）范围内的定时步态速度 (m/s)。使用混合模型，我们检查了基线步态速度（连续和四分位数）作为认知下降的预测因子，以及基线认知作为控制人口统计和医疗条件的步态速度变化的预测因子。结果。从横截面来看，更快的步态速度与更好的记忆、执行功能和整体认知表现相关。认知得分和步态速度都随着时间的推移而下降。基线时较快的步态速度与所有特定领域和整体得分的认知能力下降较少相关。在排除患有轻度认知障碍或痴呆症的人后，这些结果略有减弱。相比之下，基线认知与步态速度的变化无关。结论。我们的研究表明，缓慢的步态先于认知能力下降。步态速度可能是认知能力下降的可靠、易于实现且非侵入性的危险因素。
Background. The association between gait speed and cognition has been reported; however, there is limited knowledge about the temporal associations between gait slowing and cognitive decline among cognitively normal individuals.Methods. The Mayo Clinic Study of Aging is a population-based study of Olmsted County, Minnesota, United States, residents aged 70-89 years. This analysis included 1,478 cognitively normal participants who were evaluated every 15 months with a nurse visit, neurologic evaluation, and neuropsychological testing. The neuropsychological battery used nine tests to compute domain-specific (memory, language, executive function, and visuospatial skills) and global cognitive z-scores. Timed gait speed (m/s) was assessed over 25 feet (7.6 meters) at a usual pace. Using mixed models, we examined baseline gait speed (continuous and in quartiles) as a predictor of cognitive decline and baseline cognition as a predictor of gait speed changes controlling for demographics and medical conditions.Results. Cross-sectionally, faster gait speed was associated with better performance in memory, executive function, and global cognition. Both cognitive scores and gait speed declined over time. A faster gait speed at baseline was associated with less cognitive decline across all domain-specific and global scores. These results were slightly attenuated after excluding persons with incident mild cognitive impairment or dementia. By contrast, baseline cognition was not associated with changes in gait speed.Conclusions. Our study suggests that slow gait precedes cognitive decline. Gait speed may be useful as a reliable, easily attainable, and noninvasive risk factor for cognitive decline.