PDF(Pubmed)
Abstract：
Physical and cognitive decline at an older age is preceded by changes that accumulate over time until they become clinically evident difficulties. These changes, frequently overlooked by patients and health professionals, may respond better than fully established conditions to strategies designed to prevent disabilities and dependence in later life. The objective of this study was twofold; to provide further support for the need to screen for early functional changes in older adults and to look for an early association between decline in mobility and cognition. A cross-sectional cohort study was conducted on 95 active functionally independent community-dwelling older adults in Havana, Cuba. We measured their gait speed at the usual pace and the cognitive status using the MMSE. A value of 0.8 m/s was used as the cut-off point to decide whether they presented a decline in gait speed. A quantitative analysis of their EEG at rest was also performed to look for an associated subclinical decline in brain function. Results show that 70% of the sample had a gait speed deterioration (i.e., lower than 0.8 m/s), of which 80% also had an abnormal EEG frequency composition for their age. While there was no statistically significant difference in the MMSE score between participants with a gait speed above and below the selected cut-off, individuals with MMSE scores below 25 also had a gait speed<0.8 m/s and an abnormal EEG frequency composition. Our results provide further evidence of early decline in older adults-even if still independent and active-and point to the need for clinical pathways that incorporate screening and early intervention targeted at early deterioration to prolong the years of functional life in older age.
摘要：
年龄较大的身体和认知能力下降之前会随着时间的推移而发生变化，直到它们成为临床上明显的困难。这些变化,经常被患者和卫生专业人员忽视，可能比完全确定的条件更好地应对旨在防止以后生活中的残疾和依赖的策略。这项研究的目的是双重的；为筛查老年人早期功能变化的需要提供进一步的支持，并寻找行动能力下降与认知能力之间的早期关联。对哈瓦那95名活跃的功能独立的社区居住老年人进行了一项横断面队列研究，古巴。我们使用MMSE测量了他们以通常的速度和认知状态的步态速度。0.8m/s的值用作截止点以确定它们是否呈现步态速度的下降。还对他们休息时的EEG进行了定量分析，以寻找相关的亚临床脑功能下降。结果表明，70%的样本有步态速度恶化(即，低于0.8m/s)，其中80％的年龄也有异常的脑电图频率组成。虽然步态速度高于和低于选定截止值的参与者之间的MMSE得分没有统计学上的显着差异，MMSE评分低于25分的个体的步态速度<0.8m/s,脑电图频率组成异常.我们的结果提供了老年人早期衰退的进一步证据-即使仍然独立和活跃-并指出需要结合筛查和针对早期恶化的早期干预的临床路径，以延长老年人的功能寿命。
