Physical frailty in older persons is associated with Alzheimer disease pathology
Physical frailty in older persons is associated with Alzheimer disease pathology
复制标题
DOI：
10.1212/01.wnl.0000324864.81179.6a
复制
发表时间：
2008-08-12
期刊：
影响因子：
9.9
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
--
作者：
Buchman, Aron S.;Schneider, Julie A.;Bennett, David A.
目的：我们研究了老年人的身体虚弱与常见的年龄相关的脑病理学，包括脑梗死，路易体病理学，阿尔茨海默病（AD）pathology.Methods的程度：我们研究了脑尸检从165名死者参与者拉什记忆和衰老项目，纵向临床病理学研究老化。在年度临床评价中，根据四个组成部分（包括握力、步行8英尺的时间、身体成分和疲劳）评估身体虚弱。多元回归分析被用来检查死后神经病理结果的关系，以接近死亡的脆弱性，控制年龄，性别，和education.Results：死亡的平均年龄为88.1岁（SD = 5.7年）。AD病理学水平与接近死亡的虚弱相关（（beta）over cap = 0.252，SE = 0.077，p = 0.001），占身体虚弱方差的4%。脑梗死（（beta）over cap =-0.121，SE = 0.115，p = 0.294）和路易体病病理（beta over cap = 0.07，SE = 0.156，p = 0.678）均与虚弱无关。在控制了从末次临床评价到尸检的时间间隔后，这些相关性未发生变化。AD病理学与虚弱的相关性并不因痴呆的存在而不同，即使考虑了潜在的混杂因素，包括体力活动、帕金森症状、肺功能或慢性疾病史，包括血管危险因素、血管疾病负担、福尔斯、关节疼痛或使用抗精神病药或抗高血压药，这种相关性也没有改变。老年身体虚弱与老年痴呆症和非老年痴呆症患者的阿尔茨海默病病理学相关。
Objective: We examined the extent to which physical frailty in older persons is associated with common age-related brain pathology, including cerebral infarcts, Lewy body pathology, and Alzheimer disease (AD) pathology.Methods: We studied brain autopsies from 165 deceased participants from the Rush Memory and Aging Project, a longitudinal clinical-pathologic study of aging. Physical frailty, based on four components, including grip strength, time to walk 8 feet, body composition, and fatigue, was assessed at annual clinical evaluations. Multiple regression analyses were used to examine the relation of postmortem neuropathologic findings to frailty proximate to death, controlling for age, sex, and education.Results: The mean age at death was 88.1 years (SD = 5.7 years). The level of AD pathology was associated with frailty proximate to death ((beta) over cap = 0.252, SE = 0.077, p = 0.001), accounting for 4% of the variance of physical frailty. Neither cerebral infarcts ( (beta) over cap = -0.121, SE = 0.115, p = 0.294) nor Lewy body disease pathology ( (beta) over cap = 0.07, SE = 0.156, p = 0.678) was associated with frailty. These associations were unchanged after controlling for the time interval from last clinical evaluation to autopsy. The association of AD pathology with frailty did not differ by the presence of dementia, and this association was unchanged even after considering potential confounders, including physical activity; parkinsonian signs; pulmonary function; or history of chronic diseases, including vascular risk factors, vascular disease burden, falls, joint pain, or use of antipsychotic or antihypertensive medications.Conclusion: Physical frailty in old age is associated with Alzheimer disease pathology in older persons with and without dementia.