Differences in the association between white matter hyperintensities and gait performance among older adults with and without cognitive impairment.
Differences in the association between white matter hyperintensities and gait performance among older adults with and without cognitive impairment.
复制标题
有或没有认知障碍的老年人白质高信号与步态表现之间的关联差异。
DOI：
10.1111/ggi.14132
复制
发表时间：
2021
影响因子：
3.3
通讯作者：
Shuichi A.
中科院分区：
文献类型：
--
作者：
Sakurai R;Inagaki H;Tokumaru AM;Sakurai K;Shimoji K;Kobayashi-Cuya KE;Kitamura A;Watanabe Y;Shinkai S;Shuichi A.
目的步态障碍意味着轻微的认知障碍（CI），并与白质高强度（WMHs）的严重程度相关。然而，这种关联的认知差异尚未完全了解。本研究考察了三组认知能力不同的老年人WMHs与步态表现之间的关系。方法对150名社区老年人的步态表现和wmh进行评估，其中53名CI（迷你精神状态检查[MMSE]评分<24），63名轻度CI (MMSE评分≥24和蒙特利尔认知评估[MoCA]评分<25)，34名认知正常或保留（MMSE≥24和MoCA评分≥25）。在5米电子步道上评估步态速度和变异性。此外，通过1.5 T磁共振成像自动分割得到WMH体积。结果调整后的多元回归分析显示，在CI的老年人中，wmh越大，步态速度越慢，时间（步幅时间）和空间（步幅和步长）变异性越大。相比之下，WMH仅与轻度CI老年人和认知正常或保存的老年人的空间变异性有关。结论我们的研究结果表明，步态变异性测量对包括WMHs在内的老年人微妙的潜在神经病变更敏感。WMH和步态表现之间的认知依赖性差异表明，认知功能水平干扰了WMH和步态表现之间的关联。Geriatr Gerontol Int 2021；••: ••–••.
AimGait impairment implies subtle cognitive impairment (CI) and is associated with severity of white matter hyperintensities (WMHs). However, cognitive differences in such an association are not yet fully understood. This study examined the association between WMHs and gait performance among three cognitively different older groups.MethodsGait performance and WMHs were assessed in 150 community‐dwelling older adults, comprising 53 with CI (Mini‐Mental State Examination [MMSE] score <24), 63 with mild CI (MMSE score ≥24 and Montreal Cognitive Assessment [MoCA] score <25), and 34 who were cognitively normal or preserved (MMSE ≥24 and MoCA score ≥25). Gait velocity and variability were assessed on a 5‐m electronic walkway. Furthermore, WMH volume was derived by automated segmentation using 1.5 T magnetic resonance imaging.ResultsAdjusted multiple regression analyses showed that greater WMHs were associated with slower gait velocity and greater temporal (stride time) and spatial (stride and step lengths) variabilities among older adults with CI. In contrast, WMH was only associated with spatial variability in older adults with mild CI and in cognitively normal or preserved older adults.ConclusionsOur findings suggest that gait variability measures are more sensitive to subtle underlying neurological pathologies including WMHs in older adults. The cognitive‐dependent differences found in the association between WMHs and gait performance suggests that the level of cognitive function interferes with the association between WMH and gait performance.Geriatr Gerontol Int 2021; ••: ••–••.