Idiopathic senile gait disorders are signs of subclinical disease
Idiopathic senile gait disorders are signs of subclinical disease
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DOI：
10.1111/j.1532-5415.2000.tb04786.x
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发表时间：
2000-09-01
影响因子：
6.3
通讯作者：
Westendorp, RGJ
中科院分区：
文献类型：
--
作者：
Bloem, BR;Gussekloo, J;Westendorp, RGJ
目的：为了评估生存和死亡原因的主题与特发性老年步态disorders.Design：一个人口为基础的纵向研究设置：生存分析的最古老的老年人在莱顿85加Study.Participants：我们区分三个不同的群体根据他们的步态：正常步态的受试者（n = 25）、老年步态障碍的受试者（n = 14）和由于已知疾病而具有步态障碍的受试者（n = 87）。所有组的平均年龄为90岁（范围为87至97岁）。测量：在Cox比例风险模型中估计了5年随访期间全因死亡率和心血管死亡率的风险，并根据年龄和性别进行了调整。结果：126名受试者中有89人在随访期间死亡。三组的平均生存率不同（P对数秩= 0.01）。与正常步态的受试者相比，老年步态障碍受试者的全因死亡风险增加（RR = 2.8; 95% CI：1.1-7.3，P = .03），与已知疾病引起的步态障碍受试者相似（RR = 1.2; 95% CI：.6-2.5，P = .6）。心血管疾病引起的死亡率在三组之间也存在差异（P log-rank = 0.03）。老年步态障碍患者心血管死亡的风险是正常步态患者的2倍（RR = 2.1; 95%CI，0.4-10.3）。结论：老年步态障碍与亚临床，可能是心血管疾病有关。老年步态障碍不应被认为是正常衰老过程中不可避免的良性伴随物。
OBJECTIVES: To evaluate survival and causes of death in subjects with idiopathic senile gait disorders.DESIGN: A population-based longitudinal study.SETTING: Survival analysis of the oldest old within the Leiden 85-plus Study.PARTICIPANTS: We distinguished three different groups according to their gait: subjects with a normal gait (n = 25), subjects with senile gait disorders (n = 14), and subjects with gait disorders due to known disease (n = 87). The mean age was 90 years in all groups (range 87 to 97 years).MEASUREMENTS: The risk of all cause mortality and cardiovascular mortality was estimated over 5 years of follow-up in a Cox-proportional hazards model, adjusted for age and sex.RESULTS: Eighty-nine of 126 subjects died during follow-up. Mean survival differed among the three groups (P log-rank = .01). All cause mortality risk was increased in subjects with senile gait disorders compared with subjects with a normal gait (RR = 2.8; 95% CI, 1.1-7.3, P = .03)and was similar to subjects with gait disorders caused by known disease (RR = 1.2; 95% CI:.6-2.5, P = .6). Mortality caused by cardiovascular disease also differed among the three groups (P log-rank = .03). The risk of cardiovascular death in subjects with senile gait disorders was twofold greater than in subjects with a normal gait (RR = 2.1; 95% CI, 0.4-10.3).CONCLUSIONS: Senile gait disorders are related to subclinical, perhaps cardiovascular, disease. Senile gait disorders should not be accepted as an inevitable, benign concomitant of the normal aging process.