Association of brain pathology with the progression of frailty in older adults
Association of brain pathology with the progression of frailty in older adults
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DOI：
10.1212/wnl.0b013e318294b462
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发表时间：
2013-05-01
期刊：
影响因子：
9.9
通讯作者：
Bennett, David A.
中科院分区：
文献类型：
--
作者：
Buchman, Aron S.;Yu, Lei;Bennett, David A.
目标：我们测试的假设，大脑病理学与身体虚弱的进展速度在老年adultes.Methods：共791老年人参加宗教秩序的研究和记忆和衰老项目每年进行临床评估，从以前建立的综合措施身体虚弱的衍生和脑尸检后死亡。一个统一的神经病理学检查包括评估macroinfarcts，microinfarcts，动脉粥样硬化，小动脉硬化，阿尔茨海默病和路易体病理，黑质神经元loss.Results：平均随访死亡前为6.4年，死亡年龄为88.5岁。超过95%的病例有一种或多种脑部病变的证据。在控制年龄、性别和教育的线性混合效应模型中，虚弱程度以约0.12单位/年的速度增加（估计值0.117，SE 0.035，p>0.001）。随着年龄的增长，虚弱的进展速度加快（估计值0.002，SE 0.001，p=0.012）。在单独的模型中，大梗死、阿尔茨海默病和路易体病理学以及黑质神经元丢失的存在与更快的虚弱进展相关（所有p值
Objective: We tested the hypothesis that brain pathology is associated with the rate of progression of physical frailty in older adults.Methods: A total of 791 older adults participating in the Religious Orders Study and Memory and Aging Project had annual clinical evaluations from which a previously established composite measure of physical frailty was derived and brain autopsy after death. A uniform neuropathologic examination included the assessment of macroinfarcts, microinfarcts, atherosclerosis, arteriolosclerosis, Alzheimer disease and Lewy body pathology, and nigral neuronal loss.Results: Mean follow-up before death was 6.4 years and age at death was 88.5 years. More than 95% of cases had evidence of one or more brain pathologies. In a linear mixed-effect model controlling for age, sex, and education, frailty increased at approximately 0.12 unit/year (estimate 0.117, SE 0.035, p>0.001). The rate of progression of frailty was accelerated with increasing age (estimate 0.002, SE 0.001, p=0.012). In separate models, the presence of macroinfarcts, Alzheimer disease and Lewy body pathology, and nigral neuronal loss was associated with a more rapid progression of frailty (all p values