Functional Decline in Cognitive Impairment - The Relationship between Physical and Cognitive Function
Functional Decline in Cognitive Impairment - The Relationship between Physical and Cognitive Function
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DOI：
10.1159/000154929
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发表时间：
2008-01-01
影响因子：
5.7
通讯作者：
Woo, Jean
中科院分区：
文献类型：
--
作者：
Auyeung, Tung Wai;Kwok, Timothy;Woo, Jean
背景：身体功能下降与痴呆有关，可能与共存的骨质疏松症有关，也可能与认知功能受损有直接关系。我们的目标是检验认知功能和基于表现的身体功能之间的关系，并检验认知功能与不依赖于肌肉质量的身体功能低下有关的假设。方法：采用双能X线骨密度仪和社区痴呆筛查仪(CSI-D)的认知部分，对4000名1 65岁的社区老年人进行肌力、运动功能和肌肉质量的测定。CSI-D认知评分28.40被认为是认知障碍。采用多因素分析方法，调整年龄、附件骨量(ASM)、老年体力活动评分(PASE)及其他并存因素，分析认知障碍对肌力和身体功能的影响。结果：认知功能障碍(CSI-D认知功能评分28.40)组握力较弱(男性为-5.1 kg，P<0.001；女性为-1.08 kg，P<0.001)，在两项身体机能测试中表现较差(男性6米步行速度，-0.13m/S，P<0.001)，站椅试验，1.42 S，P<0.001；女子6米竞走速度：-0.08m/S，P；0.001；立椅测试，S：1.48P；0.001)。调整年龄、ASM、PASE等合并症后，认知障碍组与非认知障碍组握力差异显著(男性为-2.6 kg，p=0.001；女性为-0.49 kg，p=0.011)，两项身体机能测试仍存在(男性6米步行速度，-0.072 m/S，p<；0.001，椅子站立试验，0.80 S，p=0.045；女性6米步行速度，-0.049 m/S，p<；0.001，椅子站立测试，S 0.98，p<；0.001)。结论：认知功能减退与肌力减退并存。这种关系与肌肉质量无关。因此，痴呆症的功能下降可能与导致认知损害的因素直接相关，而不是与共存的骨质疏松症无关。版权所有(C)2008 S.Karger AG，巴塞尔
Background: Physical function decline is associated with dementia, which might either be mediated by the coexisting sarcopenia or directly related to the impaired cognition. Our objectives are to examine the relationship between cognitive function and performance-based physical function and to test the hypothesis that cognitive function is related to poor physical function independent of muscle mass. Methods: We measured muscle strength, performance-based physical function and muscle mass using dual-energy X-ray absorptiometry and cognitive function using the cognitive part of the Community Screening Instrument of Dementia (CSI-D) in 4,000 community-dwelling Chinese elderly aged 1 65 years. A CSI-D cognitive score of >28.40 was considered as cognitively impaired. The effect of cognitive impairment on muscle strength and physical function was analyzed by multivariate analysis with adjustment for age, appendicular skeletal mass (ASM), the Physical Activity Scale for the Elderly (PASE) and other comorbidities. Results: In both genders, the cognitively impaired (CSI-D cognitive score >28.40) group had a weaker grip strength (-5.10 kg, p < 0.001 in men; -1.08 kg in women, p < 0.001) and performed worse in the two physical function tests (in men, 6- meter walk speed, - 0.13 m/ s, p < 0.001, chair stand test, 1.42 s, p < 0.001; in women, 6- meter walk speed, - 0.08 m/ s, p < 0.001, chair stand test, 1.48 s, p < 0.001). After adjustment for age, ASM, PASE and other comorbidities, significant differences in grip strength (- 2.60 kg, p < 0.001 in men; - 0.49 kg, p = 0.011 in women) and the two physical function tests persisted between the cognitively impaired and nonimpaired group (in men, 6- meter walk speed, - 0.072 m/ s, p < 0.001, chair stand test, 0.80 s, p = 0.045; in women, 6- meter walk speed, - 0.049 m/ s, p < 0.001, chair stand test, 0.98 s, p < 0.001). Conclusions: Poor physical function and muscle strength coexisted with cognitive impairment. This relationship was independent of muscle mass. It is likely therefore that the functional decline in dementia might be related directly to factors resulting in cognitive impairment independently of the coexisting sarcopenia. Copyright (C) 2008 S. Karger AG, Basel