Association between performance on Timed Up and Go subtasks and mild cognitive impairment: further insights into the links between cognitive and motor function.

Association between performance on Timed Up and Go subtasks and mild cognitive impairment: further insights into the links between cognitive and motor function.
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DOI:
10.1111/jgs.12734
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发表时间:
2014-04
影响因子:
6.3
通讯作者:
Hausdorff JM
Hausdorff JM
中科院分区:
医学1区
文献类型:
--
作者:
Mirelman A;Weiss A;Buchman AS;Bennett DA;Giladi N;Hausdorff JM

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完成定时起身和行走(TUG)的时间,一种移动性和跌倒风险的测试,最近与认知功能相关。评估不同的TUG子任务是否优先影响轻度认知障碍(MCI)的老年人,并具体到不同的认知能力。横断面研究社区和家庭环境347名无痴呆的老年人(平均83.6± 3.5岁,75%为女性,19.3%为MCI)参加了拉什记忆和衰老项目。受试者戴着一个小的,重量轻的传感器,测量加速度和角速度,而他们执行仪器TUG(iTUG)。iTUG的测量来自4个子任务:行走,转身,坐立和站坐,并在无认知障碍(NCI)与MCI的参与者之间进行比较。NCI和MCI在年龄、性别、受教育年限(p>0.44)或完成TUG的时间(NCI:7.6± 3.7秒vs. MCI:8.4± 3.7秒;p=0.12)方面没有差异。MCI的行走一致性较低(p=0.0091),过渡期间的俯仰范围较小(p=0.005),转弯期间的角速度较低,需要更多的时间来完成转弯行走(p=0.042)。步态一致性与感知速度相关(p=0.012),转身与感知速度(p=0.024)和视觉空间能力(p=0.049)相关。MCI与iTUG子任务上的受损性能相关,当简单地测量整体性能持续时间时无法识别。独特的iTUG任务与特定的认知领域有关,表明运动认知相互作用的特异性。使用单个身体穿戴式传感器来量化移动性可能有助于我们理解晚年步态障碍及其与认知下降的相互关系。
Time to complete the Timed Up and Go (TUG), a test of mobility and fall risk, was recently associated with cognitive function. To assess whether different TUG subtasks are preferentially affected among older adults with mild cognitive impairment (MCI) and are specific to different cognitive abilities. Cross sectional study Community and home setting 347 older adults without dementia (mean 83.6±3.5yrs, 75% females, 19.3% MCI) participating in the Rush Memory and Aging Project. Subjects wore a small, light-weight sensor that measured acceleration and angular velocity while they performed the instrumented TUG (iTUG). Measures of iTUG were derived from 4 subtasks: walking, turning, sit-to-stand and stand-to-sit and compared between participants with no cognitive impairment (NCI) versus MCI. NCI and MCI did not differ in age, sex, years of education (p>0.44) or time to complete the TUG (NCI:7.6±3.7sec vs. MCI:8.4±3.7sec;p=0.12). MCI had less walking consistency (p=0.0091), smaller pitch range during transitions (p=0.005), lower angular velocity during turning, and required more time to complete the turn-to-walk (p=0.042). Gait consistency was correlated with perceptual speed (p=0.012) and turning was correlated with perceptual speed (p=0.024) and visual-spatial abilities (p=0.049). MCI is associated with impaired performance on iTUG subtasks that cannot be identified when simply measuring overall duration of performance. Distinctive iTUG tasks were related to particular cognitive domains, demonstrating the specificity of motor-cognitive interactions. Using a single body worn sensor for quantify of mobility may facilitate our understanding of late-life gait impairments and their inter-relationship with cognitive decline.
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