老年人工具性生活活动能力水平与常速行走步态特征的关联分析  

Association of gait characteristics walking at normal speed with instrumental activity of daily living in the older adults

作　　者：李宏宇 沈姞[2] 亢玉婷 庞婧[3] 张洁[2] 张驰[3] 孟雪 范国庆 施红[2] Li Hongyu;Shen Ji;Kang Yuting;Pang Jing;Zhang Jie;Zhang Chi;Meng Xue;Fan Guoqing;Shi Hong(Department of Scientific Research,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Geriatric,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;The Key Laboratory of Geriatrics,Beijing Institute of Geriatrics,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing Hospital/National Center of Gerontology of National Health Commission,Beijing 100730,China)

机构地区：[1]北京医院科研处、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [2]北京医院老年医学科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [3]北京医院、国家老年医学中心、国家卫生健康委、北京老年医学研究所、国家卫生健康委老年医学重点实验室、中国医学科学院老年医学研究院,北京100730

出　　处：《中国医学前沿杂志（电子版）》2024年第7期55-61,I0003,共8页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：国家重点研发计划“政府间国际科技创新合作”重点专项(2021YFE0111800)。

摘　　要：目的探讨老年人常速行走下步态参数特征及其与工具性生活活动能力(instrumental activity of daily living,IADL)水平的关系。方法2023年2-8月,应用方便抽样,选取北京医院60岁及以上自愿接受调查的老年人为研究对象进行横断面调查,收集研究对象的一般特征资料,采用IADL量表评估IADL水平,依据IADL是否受损将研究对象分为两组,使用多传感器可穿戴步态分析仪IDEEA采集研究对象常速行走状况下的步态参数。采用多因素Logistic回归模型分析老年人常速行走下步态参数与IADL受损发生风险的关联。结果共739例纳入研究,受损组293例,正常组446例。与正常组比较,受损组老年人时空步态参数如步速、步频和步长等降低,动力学参数如大腿摆动功、地面冲击力和脚离地角度降低,步态周期参数如单脚支撑时间等增加,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,步频、步长、跨步长、足落地控制和脚离地角度与IADL受损存在关联(P<0.05)。年龄分层分析中,≥70岁老年人群步态特征与IADL受损发生风险呈现更为显著的相关性(P<0.05)。结论IADL受损老年人步态性能下降,时空步态参数与动力学参数与老年人IADL受损关系密切。Objective To investigate the characteristics of gait parameters and their relationship with instrumental activity of daily living(IADL)in the older adults walking at normal speed.Methods From February to August 2023,older people aged 60 years and above in Beijing Hospital were selected for investigation by convenience sampling.General characteristics of the subjects and the IADL level were evaluated using questionnaire,and the multi-sensor wearable gait analyzer IDEEA was used to collect the gait parameters of the elderly while walking at normal speed.The association between gait parameters walking at normal speed and the risk of IADL impairment in the older people was analyzed using multivariate logistic regression model.Results The subjects were divided into two groups according to whether IADL was impaired or not,with 293 subjects in the IADL impaired group and 446 subjects in the normal group,aggregting to 739 subjects.Compared with the normal group,the spatiotemporal gait parameters such as speed,cadence and stride length were decreased,and the kinetic parameters such as thigh swing work,ground impact force and foot-off-ground angle were reduced,and gait cycle parameters such as single-leg support time increased in the IADL-impaired group,with a statistically significant difference(P<0.05).Multivariate logistic regression analysis showed that cadence,step length,stride length,foot landing control and foot-off-ground angle were associated with IADL impairment(P<0.05).In the age-stratified analysis,the correlation between gait characteristics and the risk of IADL impairment was more significant in the elderly population aged≥70 years(P<0.05).Conclusions Older individuals with impaired IADL demonstrate a decline in gait performance.Spatiotemporal gait parameters and kinetic parameters are closely related to IADL impairment in the older adults.

关 键 词：老年人 工具性生活活动能力 失能 步态 常速行走 

分 类 号：R161.7[医药卫生—公共卫生与预防医学]