FRONTAL CEREBRAL OXYGENATIVE AND HEMODYNAMIC ALTERATIONS IN RELATION TO FUNCITONAL DECLINE DEPRESSIVE STATUS IN AUTONOMOUS ELDERLY PERSONS

目前尚不清楚老年人日常生活能力的轻微变化是否与社区自治老年人的额叶脑循环和代谢功能障碍有关。本研究旨在从纵向和横断面上阐明社区居住区老年人立位性额叶脑氧合和血流动力学障碍与功能衰退的关系。研究对象为357名居住在农村社区的65-90岁志愿者，采用TMIG能力指数(TMIG-IC)、老年抑郁量表(GDS)和病史、近红外光谱监测额叶脑氧合和去氧合反应5min；分析(1)基础检查时左侧和右侧立位额叶脑氧合功能和血流动力学功能的差异，(2)查氏…(3)基线检查时立位额脑氧合和血流动力学功能的性别和年龄差异，(4)基线检查时TMIG-IC指数与立位额脑氧合和血流动力学功能的关系，(5)GDS评分与基线检查时立位额脑氧合和血流动力学功能的关系，(6)自主性受试者的残疾预后与基线检查时立位额脑氧合和血流动力学功能的关系，(7)自主受试者基线检查时与立位额脑氧合和血流动力学功能的关系；(8)自主性受试者基线检查时转移思维与立位额脑氧合和血流动力学功能的关系；(9)自主性受试者基线检查时自我护理预兆与立位额脑氧合和血流动力学功能的关系；(10)自主性受试者基线检查时智力活动预后与立位额叶脑氧合和血流动力学功能的关系。以及(11)自主受试者基线检查时社会角色预后与立位额脑氧合和血流动力学功能的关系。我们发现年龄对自主性老年人立位额脑氧合的影响很小，但氧合作用与功能下降和抑郁显著相关。脱氧血红蛋白浓度的轻微升高和组织氧指数的剧烈下降预示着一年后日常生活能力的丧失，特别是与冷漠有关的社会角色的丧失，而冷漠是额叶大脑功能之一。较少

It is unclear whether slight change in the everyday oompetence of olderr adults is related to frontal cerebral circulatory and metabolic dysfunction in community-dwelling autonomous elderly persons. This study aimed to clarify cross-sectionally and longitudinally the relation of orthostatic frontal cerebral oxygenative and hemodynamic dysfunction to functional decline in community-dwelling autonomous elderly persons.Subjects were 357 volunteers, 65-90 years of age, living in a rural community Subjects were evaluated and compared on the basis of the TMIG Index of Competence(TMIG-IC), Geriatric Depression Scale(GDS), and medical history, near infrared spectroscopy monitoring of frontal cerebral oxygenation and deoxygenation in response to 5-min standing; and blood pressure BP) and pulse at rest (supine position) and after 5-min standing.We analyzed (1)right and left differences of orthostatic frontal cerebral oxygenative and hemodynamic function at the baseline examination, (2)charecteri … More stics of orthostatic frontal cerebral oxygenative and hemodynamic function in subjects with cerebrovasular disease histories, (3)sex-and age-differences of orthostatic frontal cerebral oxygenative and hemodynamic function at the baseline examination, (4)the relationship between TMIG-IC index and orthostatic frontal cerebral oxygenative and hemodyamic function at the baseline examination, (5)the relationship between GDS scores and orthostatic frontal cerebral oxygenative and hemodynamic function at the baseline examination, (6)the relationship between disability-prognosis and orthostatic frontal cerebral oxygenative and hemodynarnic function at the baseline examination in autonomous subjects, (7)the relationship between and orthostatic frontal cerebral oxygenative and hemodynamic function at the baseline examinationin autonomous subjects, (8)the relationship between transfering-prongnosis and orthostatic frontal cerebral oxygenative and hemodynamic function at the baseline examination in autonomous subjects, (9)the relationship between selfcare-pregnosis and orthostatic frontal cerebral oxygenative and hemodynamic function at the baseline examination in autonomous subjects, (10)the relationship between intellectual-activity-prognosis and orthostatic frontal cerebral oxygenative and hemodynamic function at the baseline examination in autonomous subjects, and (11)the relationship between social-role-prognosis and orthostatic frontal cerebral oxygenative and hemodynamic function at the baseline examination in autonomous subjects.We found little age effect on orthostatic frontal cerebral oxygenation in autonomous older persons, but significant association of oxygenation with functional decline and depression. Slight increase in deoxyhemoglobin concentration and intensive decrease in Tissue Oxygen Index during orthostasis predicted incompetence of daily living after one year, especially inactivity of social role in relation to apathy that is one of frontal cerebral functions. Less