Dual-Task Gait Speeds Better Differentiate Patients with Cognitive Impairment from Cognitively Normal Older Adults than Single-Task Gait Speed

雙項任務行走速度較單項任務行走速度更能區辨有無認知功能障礙的老年人

朱育秀(Yu-Hsiu Chu) ； 湯佩芳(Pei-Fang Tang) ； 邱銘章(Ming-Jang Chiu) ； 陳達夫(Ta-Fu Chen)

《物理治療》 42卷1期 (2017/03) Pp. 20-31

https://doi.org/10.6215/FJPT.PTS1470799229

摘要

Purpose: Gait speed is one of the important measures for evaluating health status in older adults. This study examined whether dual-task gait speeds better differentiated older adults with mild cognitive disorders from cognitively normal ones, compared to single-task gait speeds. Methods: Twenty cognitively normal (CN) older adults, 22 older adults with mild cognitive impairment (MCI), and 20 older adults with mild Alzheimer’s disease (AD) underwent cognitive and motor function tests, the latter included gait speeds measured under single-, motor dual-, and cognition dual-task conditions and normalized to body-height. Group differences in normalized gait speeds were analyzed using analysis of covariance. Receiver operating characteristic (ROC) analysis, sensitivity, and specificity were used to determine the type of gait speed and the cutoff values that best differentiated patients with MCI or AD from the CN group. Results: The MCI and AD groups showed slower gait speeds than the CN group in all three conditions (p ＜ 0.05). Among these three gait speeds, motor dual-task gait speed at a cutoff of 0.48 m/(sec • body height [m]) best differentiated MCI from the CN group (sensitivity 100.0%, specificity 68.2%, and area under the curve [AUC] 0.92), whereas cognition dual-task gait speed at a cutoff of 0.44 m/(sec • body height [m]) best differentiated mild AD from the CN group (sensitivity 95.0%, specificity 80.0%, AUC 0.92). Conclusion: Dual-task gait speeds better differentiated mild cognitively impaired older adults from cognitively intact ones, compared to single-task gait speed, and may serve as useful adjunct clinical to help with identifying elders at risk of cognitive impairment in the community.

關鍵字

Alzheimer's disease ； Mild cognitive impairment ； Dual-task ； Single-task ； Gait speed

並列摘要

目的：行走速度是評估老年人健康狀態的要項之一。本研究探討雙項任務行走速度是否較單項任務行走速度更能區辦出老年人是否有輕度的認知障礙問題。方法：20 位認知正常(CN)、22 位輕度認知障礙(MCI) 及20 位輕度阿茲海默症(AD) 老年人接受認知及單項、動作雙項及認知雙項任務下之行走速度測試。比較三組間的身高標準化行走速度差異，並以ROC 曲線、敏感度及特異度分析決定可區辨CN 組與另外兩組的最佳行走速度種類及最佳切點(cut-off)。結果：MCI 及AD 組的三種行走速度均較CN 組慢(p ＜ 0.05)。當動作雙項任務行走速度的切點設為0.48 公尺／ ( 秒•身高[ 公尺]) 時，最能區辨MCI 及CN 組( 敏感度100.0%、特異度68.2%、ROC 曲線下方面積[AUC] 0.92)。而當認知雙項任務行走速度的切點設為0.44 公尺／ ( 秒•身高[ 公尺])時，最能區辨AD 及CN 組( 敏感度95.0%、特異度80.0%、AUC 0.92)。結論：雙項任務行走速度較單項任務行走速度更能區辦出老年人是否有輕度的認知功能障礙，因此可能作為協助辨識社區中有認知障礙風險老年人的有用臨床輔助測試。

並列關鍵字

阿茲海默症 ； 輕度認知障礙 ； 雙項任務 ； 單項任務 ； 行走速度