Regional Gray Matter Volumes Are Related to Concern About Falling in Older People: A Voxel-Based Morphometric Study
Regional Gray Matter Volumes Are Related to Concern About Falling in Older People: A Voxel-Based Morphometric Study
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DOI：
10.1093/gerona/glu242
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发表时间：
2016-01-01
影响因子：
5.1
通讯作者：
Delbaere, Kim
中科院分区：
文献类型：
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作者：
Tuerk, Carola;Zhang, Haobo;Delbaere, Kim
担心跌倒在老年人中很常见。各种相关的心理结构以及平衡不良和缓慢的步态与老年灰质（GM）体积减少有关。本研究对281名70-90岁的社区老年人进行了结构磁共振成像，探讨了跌倒担忧与体素GM体积之间的关系。使用国际福尔斯疗效量表（FES-I）评估对跌倒的担忧。对于每个参与者，使用基于体素的形态测量法生成体素GM体积，并对原始FES-I评分进行回归（p <0.05，在聚类水平上校正了家族错误）。FES-I评分与总脑体积呈负相关，（r = -.212; p为千分之一货币符号.001），通用汽车数量（r = -. 210; p为千分之一货币符号. 001）和白色物质体积（r = -. 155; p为千分之一货币符号. 001）。基于体素的形态测量学分析显示，FES-I与（i）左侧小脑和双侧枕下回（体素簇= 2，981; p < .001）以及（ii）双侧额上级回和左侧辅助运动区（体素簇= 1，900; p = .004）的GM体积之间存在显著的负相关性。视力和身体跌倒风险的额外调整并没有改变这些关联。在调整焦虑因素后，只有左侧小脑和双侧枕下回与FES-I评分呈负相关（簇内体素= 2，426; p < .001）。神经质的调整删除了FES-I和GM volumes.Our研究结果表明，担心下降是负相关的大脑体积在情绪控制和运动控制，执行功能和视觉处理的大样本的老年男性和女性的重要领域。回归分析表明，这些关系主要是由心理因素（广泛性焦虑和神经质），而不是由身体跌倒风险或视力。
Concern about falling is common in older people. Various related psychological constructs as well as poor balance and slow gait have been associated with decreased gray matter (GM) volume in old age. The current study investigates the association between concern about falling and voxel-wise GM volumes.A total of 281 community-dwelling older people aged 70-90 years underwent structural magnetic resonance imaging. Concern about falling was assessed using Falls Efficacy Scale-International (FES-I). For each participant, voxel-wise GM volumes were generated with voxel-based morphometry and regressed on raw FES-I scores (p < .05 family-wise error corrected on cluster level).FES-I scores were negatively correlated with total brain volume (r = -.212; p a parts per thousand currency sign .001), GM volume (r = -.210; p a parts per thousand currency sign .001), and white matter volume (r = -.155; p a parts per thousand currency sign .001). Voxel-based morphometry analysis revealed significant negative associations between FES-I and GM volumes of (i) left cerebellum and bilateral inferior occipital gyrus (voxels-in-cluster = 2,981; p < .001) and (ii) bilateral superior frontal gyrus and left supplementary motor area (voxels-in-cluster = 1,900; p = .004). Additional adjustment for vision and physical fall risk did not alter these associations. After adjustment for anxiety, only left cerebellum and bilateral inferior occipital gyrus remained negatively associated with FES-I scores (voxels-in-cluster = 2,426; p < .001). Adjustment for neuroticism removed all associations between FES-I and GM volumes.Our study findings show that concern about falling is negatively associated with brain volumes in areas important for emotional control and for motor control, executive functions and visual processing in a large sample of older men and women. Regression analyses suggest that these relationships were primarily accounted for by psychological factors (generalized anxiety and neuroticism) and not by physical fall risk or vision.