Gait speed as predictor of transition into cognitive impairment: Findings from three longitudinal studies on aging
Gait speed as predictor of transition into cognitive impairment: Findings from three longitudinal studies on aging
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DOI：
10.1016/j.exger.2019.110783
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发表时间：
2020-01-01
影响因子：
3.9
通讯作者：
Terrera, Graciela Muniz
中科院分区：
文献类型：
--
作者：
Hoogendijk, Emiel O.;Rijnhart, Judith J. M.;Terrera, Graciela Muniz
目的：很少有研究将缓慢的步态速度作为认知能力下降的早期标志，研究了死亡的竞争风险。目前的研究探讨之间的关联缓慢的步态速度和认知状态和死亡之间的过渡在以后的life.Methods：我们进行了协调分析的三个纵向研究，9至25年的随访。数据来自参与H70（瑞典; n = 441;年龄>= 70岁）、InCHIANTI（意大利; n = 955;年龄>= 65岁）和LASA（荷兰; n = 2824;年龄>= 55岁）的老年人。认知状态区分使用简易精神状态检查。缓慢的步态速度定义为基线时最低的性别特异性五分位数。多状态模型进行了调整，年龄，性别和education.Results：大多数效果估计指向同一方向，与缓慢的步态速度预测向前过渡。在两项队列研究中，缓慢的步态速度预示着从轻度到重度认知障碍的转变（InChianti：HR = 2.08，95%CI = 1.40 - 3.07; LASA：HR = 1.33，95%CI = 1.01 - 1.75）和从认知健康状态过渡至死亡（H70：HR = 3.30，95%CI = 1.74 - 6.28; LASA：HR = 1.70，95%CI = 1.30 - 2.21）。结论：筛查缓慢步态速度可能有助于识别有不良后果风险的老年人，如认知能力下降和死亡。然而，一旦进入更高级的认知障碍阶段，缓慢的步态速度似乎不再预示着过渡到死亡。
Objectives: Very few studies looking at slow gait speed as early marker of cognitive decline investigated the competing risk of death. The current study examines associations between slow gait speed and transitions between cognitive states and death in later life.Methods: We performed a coordinated analysis of three longitudinal studies with 9 to 25 years of follow-up. Data were used from older adults participating in H70 (Sweden; n = 441; aged >= 70 years), InCHIANTI (Italy; n = 955; aged >= 65 years), and LASA (the Netherlands; n = 2824; aged >= 55 years). Cognitive states were distinguished using the Mini-Mental State Examination. Slow gait speed was defined as the lowest sex-specific quintile at baseline. Multistate models were performed, adjusted for age, sex and education.Results: Most effect estimates pointed in the same direction, with slow gait speed predicting forward transitions. In two cohort studies, slow gait speed predicted transitioning from mild to severe cognitive impairment (InCHIANTI: HR = 2.08, 95%CI = 1.40-3.07; LASA: HR = 1.33, 95%CI = 1.01-1.75) and transitioning from a cognitively healthy state to death (H70: HR = 3.30, 95%CI = 1.74-6.28; LASA: HR = 1.70, 95%CI = 1.30-2.21).Conclusions: Screening for slow gait speed may be useful for identifying older adults at risk of adverse outcomes such as cognitive decline and death. However, once in the stage of more advanced cognitive impairment, slow gait speed does not seem to predict transitioning to death anymore.