Gait speed as predictor of transition into cognitive impairment: Findings from three longitudinal studies on aging.,Experimental Gerontology

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Gait speed as predictor of transition into cognitive impairment: Findings from three longitudinal studies on aging.
Experimental Gerontology ( IF 3.3 ) Pub Date : 2019-11-18 , DOI: 10.1016/j.exger.2019.110783
Emiel O Hoogendijk ₁ , Judith J M Rijnhart ₁ , Johan Skoog ₂ , Annie Robitaille ₃ , Ardo van den Hout ₄ , Luigi Ferrucci ₅ , Martijn Huisman ₆ , Ingmar Skoog ₇ , Andrea M Piccinin ₈ , Scott M Hofer ₈ , Graciela Muniz Terrera ₉

Affiliation

Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, the Netherlands.
Department of Psychology, Centre for Health and Ageing AGECAP, University of Gothenburg, Gothenburg, Sweden.
Département de Psychologie, Université du Québec, Montréal, QC, Canada.
Department of Statistical Science, University College London, London, UK.
National Institute on Aging, Baltimore, MD, USA.
Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC - location VU University Medical Center, Amsterdam, the Netherlands; Department of Sociology, VU University, Amsterdam, the Netherlands.
Institute of Neuroscience and Physiology, Centre for Health and Ageing AGECAP, University of Gothenburg, Gothenburg, Sweden.
Department of Psychology, University of Victoria, Victoria, BC, Canada.
Department of Psychology, University of Victoria, Victoria, BC, Canada; Centre for Dementia Prevention, The University of Edinburgh, Edinburgh, UK.

Objectives

Very few studies looking at slow gait speed as early marker of cognitive decline investigated the competing risk of death. The current study examines associations between slow gait speed and transitions between cognitive states and death in later life.

Methods

We performed a coordinated analysis of three longitudinal studies with 9 to 25 years of follow-up. Data were used from older adults participating in H70 (Sweden; n = 441; aged ≥70 years), InCHIANTI (Italy; n = 955; aged ≥65 years), and LASA (the Netherlands; n = 2824; aged ≥55 years). Cognitive states were distinguished using the Mini-Mental State Examination. Slow gait speed was defined as the lowest sex-specific quintile at baseline. Multistate models were performed, adjusted for age, sex and education.

Results

Most effect estimates pointed in the same direction, with slow gait speed predicting forward transitions. In two cohort studies, slow gait speed predicted transitioning from mild to severe cognitive impairment (InCHIANTI: HR = 2.08, 95%CI = 1.40–3.07; LASA: HR = 1.33, 95%CI = 1.01–1.75) and transitioning from a cognitively healthy state to death (H70: HR = 3.30, 95%CI = 1.74–6.28; LASA: HR = 1.70, 95%CI = 1.30–2.21).

Conclusions

Screening for slow gait speed may be useful for identifying older adults at risk of adverse outcomes such as cognitive decline and death. However, once in the stage of more advanced cognitive impairment, slow gait speed does not seem to predict transitioning to death anymore.

中文翻译：

步态速度可预测是否会转变为认知障碍：三项关于衰老的纵向研究的发现。

目标

很少有研究将步态速度缓慢作为认知能力下降的早期标志物来研究死亡的竞争风险。当前的研究检查了慢步态速度与晚年认知状态与死亡之间的转换之间的关联。

方法

我们对9到25年的随访进行了三项纵向研究的协调分析。数据来自参与H70（瑞典； n = 441；年龄≥70岁），InCHIANTI（意大利； n = 955；年龄≥65岁）和LASA（荷兰； n = 2824；年龄≥55岁）的老年人。）。认知状态使用迷你精神状态检查进行区分。慢步态速度定义为基线时性别最低的五分位数。进行了多状态模型，并针对年龄，性别和教育程度进行了调整。

结果

大多数效果估计都指向同一方向，步态速度较慢则可以预测向前过渡。在两项队列研究中，慢步态速度预测会从轻度认知障碍转变为严重认知障碍（印度：HR = 2.08，95％CI = 1.40–3.07； LASA：HR = 1.33，95％CI = 1.01-1.75），并从认知转变健康至死亡状态（H70：HR = 3.30，95％CI = 1.74–6.28； LASA：HR = 1.70，95％CI = 1.30–2.21）。