Cognitive functioning is more closely related to real-life mobility than to laboratory-based mobility parameters
Cognitive functioning is more closely related to real-life mobility than to laboratory-based mobility parameters
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DOI：
10.1007/s10433-017-0434-3
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发表时间：
2018-03-01
影响因子：
3.8
通讯作者：
Zijlstra, Wiebren
中科院分区：
文献类型：
--
作者：
Giannouli, Eleftheria;Bock, Otmar;Zijlstra, Wiebren
越来越多的证据表明，活动能力依赖于认知资源，但各种认知功能与不同活动参数之间的确切关系仍有待进一步研究。这项研究检验了这样一种假设，即认知功能与现实生活中的行动能力的关系比与标准化实验室测试中测量的行动能力的关系更密切。最后用于分析的样本包括66名老年人（72.3±5.6岁）。认知测试采用计划测试（HOTAP测试）、空间工作记忆测试（网格-广度测试）和视觉空间注意测试（注意窗口测试）。移动能力通过仪器版本的定时起跳测试（iTUG）进行评估。研究人员通过智能手机评估参与者的移动能力，智能手机收集了一周内的加速度计和GPS数据，以确定他们在现实生活中活动的空间范围和时间持续时间。数据分析包括探索性因素分析和相关性分析。活动能力测量被简化为四个正交因素：“现实生活中的活动能力”因素与大多数认知测量显著相关（r = 0.229至r = 0.396）；代表“坐到站的转换”和“转身”的因素与较少的认知测量相关（分别在r = 0.271和r = 0.315之间和r = 0.210和r = 0.316之间），而代表笔直步态的因素仅与一项认知测量相关（r = 0.237）。在被测试的认知功能中，视觉空间注意与大多数活动测量相关，执行功能与较少的活动测量相关，而空间工作记忆仅与一种活动测量相关。能力和现实生活中的表现代表了机动性的不同方面。现实生活中的行动能力与认知的关系比与行动能力的关系更密切，在我们的数据中，这种联系在视觉空间注意力方面最为明显。现实生活中的行动能力和视觉空间注意力之间的密切联系应该在针对老年行动能力的干预措施中得到考虑。
Increasing evidence indicates that mobility depends on cognitive resources, but the exact relationships between various cognitive functions and different mobility parameters still need to be investigated. This study examines the hypothesis that cognitive functioning is more closely related to real-life mobility performance than to mobility capacity as measured with standardized laboratory tests. The final sample used for analysis consisted of 66 older adults (72.3 +/- 5.6 years). Cognition was assessed by measures of planning (HOTAP test), spatial working memory (Grid-Span test) and visuospatial attention (Attention Window test). Mobility capacity was assessed by an instrumented version of the Timed Up-and-Go test (iTUG). Mobility performance was assessed with smartphones which collected accelerometer and GPS data over one week to determine the spatial extent and temporal duration of real-life activities. Data analyses involved an exploratory factor analysis and correlation analyses. Mobility measures were reduced to four orthogonal factors: the factor 'real-life mobility' correlated significantly with most cognitive measures (between r = .229 and r = .396); factors representing 'sit-to-stand transition' and 'turn' correlated with fewer cognitive measures (between r = .271 and r = .315 and between r = .210 and r = .316, respectively), and the factor representing straight gait correlated with only one cognitive measure (r = .237). Among the cognitive functions tested, visuospatial attention was associated with most mobility measures, executive functions with fewer and spatial working memory with only one mobility measure. Capacity and real-life performance represent different aspects of mobility. Real-life mobility is more closely associated with cognition than mobility capacity, and in our data this association is most pronounced for visuospatial attention. The close link between real-life mobility and visuospatial attention should be considered by interventions targeting mobility in old age.