Associations of gait speed and other measures of physical function with cognition in a healthy cohort of elderly persons
Associations of gait speed and other measures of physical function with cognition in a healthy cohort of elderly persons
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DOI：
10.1093/gerona/62.11.1244
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发表时间：
2007-11-01
影响因子：
5.1
通讯作者：
Williamson, Jeff D.
中科院分区：
文献类型：
--
作者：
Fitzpatrick, Annette L.;Buchanan, Catherine K.;Williamson, Jeff D.
背景。最近的证据表明，身体衰退和步态缓慢可能与痴呆症的早期症状有关，但需要更多关于健康老年人的信息。方法。我们在 2000-2001 年进行的 Ginkgo 记忆评估研究中，确定了 3035 名健康移动参与者的认知功能、步态速度和自我报告的身体功能测量之间的关联。步态速度是在 15 英尺长的路线上测量的，参与者以平常的速度和快速的速度行走。还收集了自我报告的日常生活活动（ADL）和其他身体功能任务的困难。改良简易精神状态检查 (3MSE) 的结果确定了认知功能。结果。该队列的平均年龄为 78.6 岁（标准差 [SD] 3.3），53.9% 的参与者为男性。正常步速下的平均步态速度为 0.95 (SD 0.23) m/s，快速步态下的平均步态速度为 1.35 (SD 0.58) m/s。超过四分之三的参与者的 3MSE 分数 > 90。在针对人口统计和合并症进行调整的多个逻辑模型中，快步步行任务中最慢四分位数的参与者的低认知风险（定义为 3MSE 分数为 80-85）几乎是最快步行者的两倍（比值比：1.96，95% 置信区间，1.25-3.08）。认知与正常节奏步行之间的关联处于边缘状态，并且未发现与自我报告的身体机能测量（包括 ADL）之间的关系。结论。在非常健康的老年人中，基于表现的测量比主观测量更好地预测早期认知能力下降，而需要更大功能储备的任务（例如快节奏步行）似乎在评估这些关系时最敏感。
Background. Recent evidence suggests that physical decline and slower gait may be associated with early signs of dementia, but more information on healthy older adults is needed.Methods. We determined associations between cognitive function, gait speed, and self-reported measures of physical function in 3035 healthy mobile participants of the Ginkgo Evaluation of Memory Study evaluated in 2000-2001. Gait speed was measured over a 15-foot course with participants walking at both their usual and rapid pace. Self-reported difficulties with Activities of Daily Living (ADLs) and other physical function tasks were also collected. Results of the Modified Mini-Mental State Examination (3MSE) determined cognitive function.Results. The average age of the cohort was 78.6 years (standard deviation [SD] 3.3), and 53.9% of participants were men. Mean gait speed was 0.95 (SD 0.23) m/s at a usual pace and 1.35 (SD 0.58) m/s at a rapid pace. More than three-fourths of participants had 3MSE scores > 90. In multiple logistic models adjusted for demographics and comorbidities, risk of low cognition (defined as 3MSE score of 80-85) was almost twice as great for participants in the slowest quartile of the rapid-paced walking task than for the fastest walkers (odds ratio: 1.96, 95% confidence interval, 1.25-3.08). Associations between cognition and usual-paced walking were borderline, and no relationships were found with self-reported measures of physical function, including ADLs.Conclusions. In very healthy older adults, performance -based measures better predict early cognitive decline than do subjective measures, and tasks requiring greater functional reserve, such as fast-paced walking, appear to be the most sensitive in assessing these relationships.