Cognitive function is associated with the development of mobility impairments in community-dwelling elders.
Cognitive function is associated with the development of mobility impairments in community-dwelling elders.
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DOI：
10.1097/jgp.0b013e3181ef7a2e
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发表时间：
2011-06
期刊：
影响因子：
--
通讯作者：
Bennett DA
中科院分区：
文献类型：
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作者：
Buchman AS;Boyle PA;Leurgans SE;Barnes LL;Bennett DA
研究认知功能与老年人发生活动障碍的风险和活动能力下降的比率之间的关系。前瞻性、观察性队列研究。芝加哥大都市的退休社区。来自两项纵向研究的1154名门诊老年人，没有基线的临床痴呆或中风或帕金森病病史。所有参与者都接受了基线认知测试和年度行动能力测试。行动能力障碍是基于每年的定时步行表现。一种总结步态和平衡措施的综合活动能力测量被用来检查活动能力的年变化率。在4.5年的随访中，836名参与者中有423名(50.6%)出现了行动不便。在控制了年龄、性别、教育程度和种族的比例风险模型中，基线全局认知水平每高1个单位，行动能力障碍的风险就会降低到大约一半(HR=0.51，95%CI 0.40，0.66)，这与参与者在基线时年轻约13岁类似。这些结果不受性别或种族的影响，在控制体重指数、体力活动、血管疾病和风险因素的分析中也没有变化。5种不同认知能力的认知水平也与事件活动障碍有关。认知能力与意外事件中行走能力的丧失有类似的关联。线性混合效应模型表明，基线时的全球认知与流动性下降的速度有关。在非卧床老年人中，认知与意外行动能力受损和行动能力下降有关。
To examine the association of cognitive function with the risk of incident mobility impairments and the rate of declining mobility in older adults. Prospective, observational cohort study. Retirement communities across metropolitan Chicago. 1154 ambulatory elders from two longitudinal studies without baseline clinical dementia or history of stroke or Parkinson’s disease. All participants underwent baseline cognitive testing and annual mobility exams. Mobility impairments were based on annual timed walking performance. A composite mobility measure which summarized gait and balance measures was used to examine the annual rate of mobility change. During follow-up of 4.5 years, 423 of 836 (50.6%) participants developed impaired mobility. In a proportional hazards model controlled for age, sex, education and race, each 1-unit higher level of baseline global cognition was associated with a reduction to about half in the risk of mobility impairments (HR=0.51, 95% CI 0.40, 0.66) and was similar to a participant being about 13 years younger at baseline. These results did not vary by sex or race and were unchanged in analyses controlling for BMI, physical activity, vascular diseases and risk factors. The level of cognition in 5 different cognitive abilities was also related to incident mobility impairment. Cognition showed similar associations with incident loss of the ability to ambulate. Linear mixed-effects models showed that global cognition at baseline was associated with the rate of declining mobility. Among ambulatory elders, cognition is associated with incident mobility impairment and mobility decline.