Subsystems contributing to the decline in ability to walk: Bridging the gap between epidemiology and geriatric practice in the InCHIANTI study
Subsystems contributing to the decline in ability to walk: Bridging the gap between epidemiology and geriatric practice in the InCHIANTI study
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DOI：
10.1111/j.1532-5415.2000.tb03873.x
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发表时间：
2000-12-01
影响因子：
6.3
通讯作者：
Guralnik, JM
中科院分区：
文献类型：
--
作者：
Ferrucci, L;Bandinelli, S;Guralnik, JM
背景：老年患者经常因为行走困难而被转介到老年科医生那里。对这些患者的诊断和治疗方法是复杂的。多个生理子系统可能影响行走能力，目前没有标准标准可用于确定这些子系统是否在正常范围内运行。为了解决这一知识的缺乏，我们进行了InChianti研究。目的：确定临床医生可以用来了解老年人行走困难的原因的措施。设计：一项以居住在Chianti地理区域的人群为基础的研究（托斯卡纳，意大利）参加者：1453人（年龄范围20-102岁; 91.6%的合格者），选自基安蒂的基安蒂的格雷夫和巴尼奥阿里波利市登记处（托斯卡纳，意大利），使用多阶段抽样方法。测量：影响步行能力的因素分为六个主要的生理子系统：中枢神经系统，感知系统，周围神经系统，肌肉，骨/关节，和能量产生/传递。确定了这些拟议子系统中每一个的完整性和功能的测量值，并向所有参与者进行了管理。InCHIANTI中收集的数据将用于识别影响老年人行走能力丧失的主要风险因素，定义对行走至关重要的生理子系统，选择其完整性的最佳衡量标准，并在这些测量中建立与“正常”行走能力相容的临界范围。最终目标是将流行病学研究转化为老年临床工具，使行走功能障碍患者的诊断和治疗更加准确。
BACKGROUND: Older patients are often referred to geriatricians because of complaints of progressive difficulties in walking. The diagnostic and therapeutic approach to these patients is complex. Multiple physiologic subsystems may influence the ability to walk, and no standard criteria are currently available to establish whether these subsystems are functioning within the normal range. To address this lack of knowledge we conducted the InCHIANTI study.OBJECTIVE: To identify measures that clinicians can use to understand the causes of walking difficulties in older persons.DESIGN: A population-based study of persons living in the Chianti geographic area (Tuscany, Italy).PARTICIPANTS: 1453 persons (age-range 20-102 years; 91.6% of the eligible) selected from city registry of Greve in Chianti and Bagno a Ripoli (Tuscany, Italy), using a multistage sampling method.MEASUREMENTS: Factors that influence walking ability were classified into six main physiologic subsystems: central nervous system, perceptual system, peripheral nervous system, muscles, bone/joints, and energy production/delivery. Measures of the integrity and functioning of each of these proposed subsystems were identified and administered to all participants.CONCLUSIONS: Data collected in InCHIANTI will be used to identify the main risk factors that influence loss of the ability to walk in older persons, to define physiologic subsystems that are critical for walking, to select the brst measures of their integrity, and to establish critical ranges in these measures that are compatible with "normal" walking ability. The final goal is to translate epidemiological research into a geriatric clinical tool that makes possible more precise diagnosis and more effective treatment in patients with walking dysfunction.