Association Between Accelerated Multimorbidity and Age-Related Cognitive Decline in Older Baltimore Longitudinal Study of Aging Participants without Dementia.
Association Between Accelerated Multimorbidity and Age-Related Cognitive Decline in Older Baltimore Longitudinal Study of Aging Participants without Dementia.
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DOI：
10.1111/jgs.14092
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发表时间：
2016-05
影响因子：
6.3
通讯作者：
Ferrucci L
中科院分区：
文献类型：
--
作者：
Fabbri E;An Y;Zoli M;Tanaka T;Simonsick EM;Kitner-Triolo MH;Studenski SA;Resnick SM;Ferrucci L
探讨非痴呆老年人身体健康恶化率与认知功能纵向下降之间的关系。纵向研究（巴尔的摩老龄化纵向研究，BLSA）社区756名65岁或以上的BLSA参与者，平均随访3年，基线和随访均无痴呆或轻度认知障碍。标准化的神经认知测试评估精神状态、记忆、执行功能、处理速度和语言流畅性。在每次访问时，根据预先定义的清单评估诊断出的慢性疾病的数量。慢性疾病的快速积累被定义为疾病数量随时间变化率的上四分位数（≥0.25种疾病/年）。慢性疾病的快速积累与类别和字母流畅性测试的更大下降率显著相关（P= 0.015和P= 0.013）。类似的趋势也出现在轨迹测试A和B中（P<0.1），而与视觉和言语记忆的变化率没有关联。虽然需要进一步的研究来验证我们的结果并充分了解潜在的机制，但这些发现表明，在非痴呆老年人中，身体健康的加速恶化与特定认知领域的加速衰退有关。
To explore the association between the rate of physical health deterioration, operationalized as rising multi-morbidity overtime, and the longitudinal decline in cognitive function in non-demented older adults. Longitudinal Study (Baltimore Longitudinal Study of Aging, BLSA) Community 756 BLSA participants, aged 65 or older, followed for an average of 3 years and free of dementia or mild cognitive impairment both at baseline and follow-ups. Standardized neurocognitive tests evaluating mental status, memory, executive function, processing speed and verbal fluency were administered. Multi-morbidity was assessed at each visit as number of diagnosed chronic diseases from a pre-defined list. Faster accumulation of chronic diseases was defined as upper quartile of rate of change in number of diseases over time (≥0.25 diseases/year). Faster accumulation of chronic diseases was significantly associated with greater rate of decline in Category and Letter Fluency Tests (P=.015 and P=.013 respectively). Similar trends were also found for Trail Making Tests A and B (P<0.1), while no association was found with rate of change in visual and verbal memory. Although further investigations are required to validate our results and fully understand the underlying mechanisms, these findings suggest that accelerated deterioration of physical health is associated with accelerated decline with aging in specific cognitive domains in non-demented older adults.