Quantitative gait dysfunction and risk of cognitive decline and dementia
Quantitative gait dysfunction and risk of cognitive decline and dementia
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DOI：
10.1136/jnnp.2006.106914
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发表时间：
2007-09-01
影响因子：
11
通讯作者：
Xue, Xiaonan
中科院分区：
文献类型：
--
作者：
Verghese, Joe;Wang, Cuiling;Xue, Xiaonan
背景：识别临床前痴呆的定量步态标记物可能会带来对疾病早期阶段的新见解，改善诊断评估，并确定新的预防策略。目的：研究定量步态参数与特定认知领域的下降以及老年痴呆发病风险的关系。方法：我们进行了一项嵌套在社区老龄化研究中的前瞻性队列研究。在接受步态定量评估的427名年龄在70岁及以上的受试者中，399人在基线状态下没有痴呆。结果：经过5年以上的随访(中位数2年)，33名受试者发展为痴呆症。因子分析被用来将8个基线定量步态参数简化为代表速度、节奏和变异性的3个独立因素。在线性模型中，节奏因素增加1分与记忆力进一步下降(增加107%)有关，而速度因素与通过数字符号替代(29%)和字母流利性(92%)测试测量的执行功能下降有关。在调整了年龄、性别和教育程度的COX模型中，基线节律(危险比(HR)1.48；95%可信区间1.03至2.14)和变异性因素得分(危险比1.37；95%可信区间1.05至1.78)增加1点与痴呆风险增加相关。步速因素可预测发生血管性痴呆的风险(HR为1.60；95%CI为1.06至2.41)。结论：我们的研究结果表明，定量步态测量可预测最初未患痴呆症的老年人未来认知功能下降和痴呆的风险。
Background:Identifying quantitative gait markers of preclinical dementia may lead to new insights into early disease stages, improve diagnostic assessments and identify new preventive strategies.Objective:To examine the relationship of quantitative gait parameters to decline in specific cognitive domains as well as the risk of developing dementia in older adults.Methods:We conducted a prospective cohort study nested within a community based ageing study. Of the 427 subjects aged 70 years and older with quantitative gait assessments, 399 were dementia-free at baseline.Results:Over 5 years of follow-up (median 2 years), 33 subjects developed dementia. Factor analysis was used to reduce eight baseline quantitative gait parameters to three independent factors representing pace, rhythm and variability. In linear models, a 1 point increase on the rhythm factor was associated with further memory decline (by 107%), whereas the pace factor was associated with decline on executive function measured by the digit symbol substitution (by 29%) and letter fluency (by 92%) tests. In Cox models adjusted for age, sex and education, a 1 point increase on baseline rhythm (hazard ratio (HR) 1.48; 95% CI 1.03 to 2.14) and variability factor scores (HR 1.37; 95% CI 1.05 to 1.78) was associated with increased risk of dementia. The pace factor predicted the risk of developing vascular dementia (HR 1.60; 95% CI 1.06 to 2.41).Conclusion:Our findings indicate that quantitative gait measures predict future risk of cognitive decline and dementia in initially non-demented older adults.