Constricting Life Space and Likelihood of Neurodegenerative Disease in Community-Dwelling Older Men.
Constricting Life Space and Likelihood of Neurodegenerative Disease in Community-Dwelling Older Men.
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DOI：
10.1001/jamanetworkopen.2023.42670
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发表时间：
2023-11-01
影响因子：
13.8
通讯作者：
Yaffe, Kristine
中科院分区：
文献类型：
--
作者：
Bock, Meredith A.;Hoang, Tina;Cawthon, Peggy;Mackey, Dawn C.;Patel, Sheena;Hillier, Teresa A.;Yaffe, Kristine
生活空间的改变(在环境中活动的频率、范围和独立性)是否与社区居住的老年男性中发生的神经退行性疾病或认知能力下降有关？在这项对1684名男性进行的队列研究中，生活空间减少1个SD的人口平均值与7年来痴呆症发病几率增加约60%以及全球认知和执行功能下降有关。这些发现表明，临床医生对生活空间或可穿戴电子设备的评估可能有助于识别有认知能力下降和神经退行性疾病风险的老年人。这项队列研究评估了居住在社区的老年男性7年来生活空间的变化与认知能力下降或发生神经退行性疾病的关系。生活空间变化是对在环境中移动的频率、范围和独立性的衡量标准。生命空间是对在环境中运动的频率、范围和独立性的衡量。越来越多的人对生活空间作为老年人功能的整体衡量标准感兴趣，但生活空间的变化与发生的神经退行性疾病之间的联系尚不清楚。评估居住在社区的老年男性7年来生活空间的改变与认知能力下降或发生神经退行性疾病之间的关系。在这项队列研究中，使用Logistic回归分析来检查基线和生活空间的变化与未经人口统计学、心血管危险因素、抑郁症、步速和体力活动调整的认知变化的关系。使用混合线性效应模型来评估生活空间变化与认知变化之间的关联。研究人员从美国6个地点招募了男性，参与了一项基于社区的前瞻性队列研究，并从2007年至2014年进行了跟踪调查。基线时患有痴呆症或帕金森病(PD)的患者被排除在外。分析了2022年5月至2023年9月的数据。生活空间，使用阿拉巴马大学伯明翰分校的生活空间评估，分为三层。参与者在基线和7年后完成了改良的简易精神状态(3MS)测试和连线测试B部分。在随访中，参与者被问及医生对痴呆症和帕金森病的新诊断。总共招募了1684名男性(平均年龄77.1[4.2]岁)，并进行了超过7年的随访，其中80名男性(4.8%)发展为痴呆症，23名男性(1.4%)发展为帕金森病。平均生活空间评分(SD)为92.9(18.7)分，平均变化(SD)为−9.9(2 2.3)分。在调整后的模型中，生活空间中每一次1-SD的减少都与痴呆症的增加相关(优势比[OR]，1.59；95%CI，1.28-1.98)，但与PD无关(OR，1.48；95%CI，0.97-2.25)。7年来，生活空间中的1-SD每减少一次，男性的Trails B得分(P <； .001)恶化20.6秒(95%CI，19.8-21.1)秒，3MS得分(P <； .001)下降1.2%(95%CI，1.0-1.3)。在这项对1684名男性长达7年的跟踪调查中，生活空间的改变与认知能力下降和神经退行性疾病的可能性增加有关。未来的研究应该检查临床医生评估或可穿戴电子设备在跟踪有认知能力下降和神经退行性疾病风险的老年人的生活空间方面的作用。
Is change in life space (the frequency, range, and independence of movement through the environment) associated with incident neurodegenerative disease or cognitive decline in community-dwelling older men? In this cohort study of 1684 men, a decline in life space by 1 SD of the population mean was associated with approximately 60% increased odds of incident dementia and decline in global cognition and executive function over 7 years. These findings suggest that clinician assessments of life space or wearable electronics may help identify older adults at risk of cognitive decline and neurodegenerative disease. This cohort study evaluates associations of change in life space, a measure of the frequency, range, and independence of movement through the environment, with cognitive decline or incident neurodegenerative disease over 7 years among community-dwelling older men. Life space is a measure of the frequency, range, and independence of movement through the environment. There is increasing interest in life space as a holistic measure of function in older adults, but the association between change in life space and incident neurodegenerative disease is unknown. To evaluate the association between change in life space and cognitive decline or incident neurodegenerative disease over 7 years among community-dwelling older men. In this cohort study, logistic regression analyses were used to examine the association of baseline and change in life space with change in cognition unadjusted and adjusted for demographics, cardiovascular risk factors, depression, gait speed, and physical activity. Mixed linear effects models were used to evaluate the association between change in life space and change in cognition. Men were recruited from 6 US sites to participate in a prospective, community-based cohort study of aging and followed-up from 2007 to 2014. Individuals with prevalent dementia or Parkinson disease (PD) at baseline were excluded. Data were analyzed from May 2022 to September 2023. Life space, assessed using the University of Alabama at Birmingham Life Space Assessment and divided into tertiles. Participants completed the Modified Mini-Mental State (3MS) Test, and Trail-Making Test Part B at baseline and 7 years later. At follow-up, participants were asked about a new physician diagnosis of dementia and PD. A total of 1684 men (mean [SD] age, 77.1 [4.2] years) were recruited and over 7 years of follow-up, 80 men (4.8%) developed dementia and 23 men (1.4%) developed PD. Mean (SD) life space score was 92.9 (18.7) points and mean (SD) change was −9.9 (22.3) points over follow up. In the adjusted model, each 1-SD decrement in life space was associated with increased odds of dementia (odds ratio [OR], 1.59; 95% CI, 1.28-1.98) but not PD (OR, 1.48; 95% CI, 0.97-2.25). For each 1-SD decrement in life space, men worsened by 20.6 (95% CI, 19.8-21.1) seconds in their Trails B score (P < .001) and declined by 1.2 (95% CI, 1.0-1.3) points in their 3MS score (P < .001) over 7 years. In this study of 1684 men followed up over 7 years, change in life space was associated with faster cognitive decline and increased likelihood of neurodegenerative illness. Future studies should examine the role of clinician assessments or wearable electronics in tracking life space in older adults at risk of cognitive decline and neurodegenerative illness.
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影响因子：
6.3
作者：
Kotwal AA;Cenzer IS;Waite LJ;Covinsky KE;Perissinotto CM;Boscardin WJ;Hawkley LC;Dale W;Smith AK
通讯作者：
Smith AK
影响因子：
6
作者：
Regnault, Antoine;Boroojerdi, Babak;Cano, Stefan
通讯作者：
Cano, Stefan
影响因子：
1.8
作者：
Barnes, Lisa L.;Wilson, Robert S.;Bennett, David A.
通讯作者：
Bennett, David A.
影响因子：
2.2
作者：
Orwoll, E;Blank, JB;Stone, K
通讯作者：
Stone, K
影响因子：
6.3
作者：
Boyle PA;Buchman AS;Barnes LL;James BD;Bennett DA
通讯作者：
Bennett DA