不同认知任务对轻度认知障碍老年人步行速度和双重任务消耗的影响研究  

Influence of various cognitive tasks on gait speed and dual task costs in patients with mild cognitive im⁃pairment

作　　者：朱奕 钟倩 马锦辉 周秋敏 沈滢 吴含 高雅新 Ali Nawab 吴希希[5] 孙翠云[4] 余滨宾 王彤 ZHU Yi;ZHONG Qian;MA Jinhui(The First Affiliated Hospital of Nanjing Medical University,Jiangsu,210029)

机构地区：[1]南京医科大学第一附属医院康复医学中心,南京210029 [2]南京医科大学第一临床医学院 [3]加拿大McMaster大学健康研究方法、证据和影响系 [4]南京大学医学院附属鼓楼医院康复医学科 [5]江苏省人民医院钟山康复分院

出　　处：《中国康复医学杂志》2020年第12期1422-1427,共6页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金青年科学基金项目(81802244);国家自然科学基金面上项目(81772454);国家自然科学基金面上项目(81971237);江苏省科技厅临床前沿技术(BE2017734);国家重点研发计划(2018YFC2001600,2018YFC2001603)。

摘　　要：目的:探索不同认知任务对轻度认知障碍(mild cognitive impairment,MCI)和正常老年人(normal cognition,NC)步行速度和双重任务消耗(dual-task costs,DTC)的影响。方法:根据最新诊断标准入组MCI和NC老年人,采用2m长的电子步道进行双重任务步态采集。每位受试者完成一项单任务步行和4项不同认知任务的双重任务步行(步行+计算,步行+说动物名,步行+记忆故事,步行+记忆词语)。计算不同任务下的步行速度和DTC并分析其组间差异。DTC是指单任务和双重任务步行速度之间差异的百分比:[(单任务速度-双重任务速度)/单任务速度]×100%。结果:本研究入组MCI老年人18人和NC老年人25人。两组间年龄、性别、教育年限等基线数据组间没有差异(P>0.05)。MCI和NC的四个不同认知任务之间存在显著性差异(P=0.004,P=0.010)。MCI仅有记忆单词下双重任务步行速度的DTC显著高于NC组(P=0.034)。结论:MCI和NC老年人不同认知任务下的DTC存在显著性差异。MCI老年人记忆单词的双重任务DTC显著高于正常老年人。Objective:Previous studies show that dual-task gait(DTG)speed is an indicator of the progression of mild cognitive impairment(MCI)to Alzheimer's Disease(AD).However,the influence of different cognitive tasks on gait speed and dual-task costs(DTC)remains unclear in such patients.Our study was aimed to investigate this influence.Method:All the participants went through dual-task gait analysis in a gait lab using two-meter electronic walkways(Zebris,FDM-2).Each participant completed one single-task walk and four dual-task walks(walk with calculation,animal naming,story memory and words memory respectively)with self-selected speed.Gait speed and DTC were calculated based on the captured data.DTC was defined as the percentage change between single and dual-task gait speed:[(single-task gait speed—dual-task gait speed)/single-task gait speed]×100.One way ANOVA and subsequent post-hoc tests were applied to compare the DTC performance of various cognitive tasks in patients with MCI and normal cognitive(NC)sample.While independent samples t-test was used to analyze the difference of DTC with each cognitive task between groups.Result:Totally 18 participants diagnosed with MCI and 25 normal controls were included in this study.The characteristics including age,gender and education years were balanced between groups(P>0.05).One-wayANOVA showed significant difference in all four cognitive tasks in MCI patients(P=0.004)and NCs(P=0.010).The independent t-test showed that only DTC of words memory in MCI group was significantly higher than the NCs(P=0.034).Conclusion:Dual-task costs have significant differences among different cognitive tasks in MCI patients and NCs.Words memory task has the highest cognitive cost in patients with MCI comparing to NC.

关 键 词：轻度认知障碍 步态 双重任务 

分 类 号：R493[医药卫生—康复医学] R743[医药卫生—临床医学]