Cognitive function, gait speed decline, and comorbidities: The health, aging and body composition study
Cognitive function, gait speed decline, and comorbidities: The health, aging and body composition study
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DOI：
10.1093/gerona/62.8.844
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发表时间：
2007-08-01
影响因子：
5.1
通讯作者：
Kritchevsky, Stephen B.
中科院分区：
文献类型：
--
作者：
Atkinson, Hal H.;Rosano, Caterina;Kritchevsky, Stephen B.
背景新出现的证据表明，认知功能和晚年的身体表现之间存在关联。本研究探讨了高功能老年人的认知功能和随后的步态速度下降之间的关系。在1999-2000年的健康、衰老和身体成分研究中获得了整体认知功能（改良简易精神状态检查[3 MS]）和执行控制功能（ECF）（时钟绘制任务[CLOX 1]和15项执行访谈[EXIT 15]）的测量结果。以正常配速在20米范围内评估步态速度（米/秒）。使用混合模型，我们评估了基线认知功能和3年内步态速度变化之间的关系。2349名老年人（平均年龄75.6 ± 2.9岁）完成了评估。在调整基线步态速度后，每项认知测试的1个标准差（SD）较低的表现与3年内更大的步态速度下降相关：3 MS为0.016 m/s（SD = 8.1），CLOX 1为0.009 m/s（SD 2.4），EXIT 15为0.012 m/s（SD = 4.1）（所有p <0.0005）。调整合并症后，3 MS和CLOX 1的效应量减弱，EXIT 15的相关性不再显著。抑郁评分与EXIT 15效应降低的相关性最强。整体和执行认知功能预测步态速度下降。ECF与步态速度下降的关联被共病条件，特别是抑郁症减弱。阐明这些关联的机制可能会为治疗与认知功能下降相关的身体衰退指明新的途径。
Background. Emerging evidence indicates an association between cognitive function and physical performance in late life. This study examines the relationship between cognitive function and subsequent gait speed decline among high-functioning older adults.Methods. Measures of global cognitive function (Modified Mini Mental State Examination [3MS]) and executive control function (ECF) (a clock drawing task [CLOX 1] and the 15-item Executive Interview [EXIT 15]) were obtained in the Health, Aging, and Body Composition Study in 1999-2000. Gait-speed (meters/second) was assessed over 20 meters at usual pace. Using a mixed model, we assessed the relationship between baseline cognitive function and gait-speed change over 3 years.Results. Two thousand, three hundred forty-nine older adults (mean age 75.6 +/- 2.9 years) completed the assessments. After adjustment for baseline gait speed, a 1-standard-deviation (SD) lower performance on each cognitive test was associated with greater gait-speed decline over 3 years: 0.016 m/s for the 3MS (SD = 8.1), 0.009 m/s for CLOX 1 (SD 2.4), and 0.012 m/s for EXIT 15 (SD = 4.1) (p < .0005 for all). After adjustment for comorbidities, the effect size was attenuated for 3MS and CLOX 1, and the association for EXIT 15 was no longer significant. Depression score was most strongly associated with the EXIT 15 effect reduction.Conclusion. Global and executive cognitive functions predict declines in gait speed. The association of ECF with gait speed decline is attenuated by comorbid conditions, particularly depression. Elucidation of the mechanisms underlying these associations may point to new pathways for the treatment of physical decline associated with diminished cognitive function.