Dual decline in gait speed and cognition is associated with future dementia: evidence for a phenotype.
Background concurrent declines in gait speed and cognition have been associated with future dementia. However, the clinical profile of 'dual decliners', those with concomitant decline in both gait speed and cognition, has not been yet described. We aimed to describe the phenotype and the risk for in...
| Publicado en: | Age & Ageing Vol. 49; no. 6; pp. 995 - 1003 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Nov2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=146608392&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 146608392 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Nov2020 vid: 49 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 146608392 10.1093/ageing/afaa106 ppf: 995 ppct: 8 formats: tig: atl: Dual decline in gait speed and cognition is associated with future dementia: evidence for a phenotype. aug: au: Montero-Odasso, Manuel Speechley, Mark Muir-Hunter, Susan W Pieruccini-Faria, Frederico Sarquis-Adamson, Yanina Hachinski, Vladimir Bherer, Louis Borrie, Michael Wells, Jennie Garg, Amit X Tian, Qu Ferrucci, Luigi Bray, Nick W Cullen, Stephanie Mahon, Joel Titus, Josh Camicioli, Richard Network, The Canadian Gait and Cognition affil: Gait and Brain Lab , Parkwood Institute, Lawson Health Research Institute , London, ON, Canada Department of Medicine and Division of Geriatric Medicine , Schulich School of Medicine and Dentistry, The University of Western Ontario , London, ON, Canada Department of Epidemiology and Biostatistics , The University of Western Ontario , London, ON, Canada Department of Clinical Neurological Sciences , The University of Western Ontario , London, ON, Canada Department of Medicine , Université de Montréal , Montreal, QC, Canada Montreal Heart Institute , and Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada Translational Gerontology Branch Longitudinal Studies Section , National Institute on Aging , Baltimore, MD, USA School of Kinesiology , The University of Western Ontario , London, ON, Canada Division of Neurology and Department of Medicine , University of Alberta , Edmonton, AB, Canada su: Canada Health status indicators Hypertension Old age Dementia risk factors Geriatric assessment Chi-squared test Cognitive testing Comparative studies Confidence intervals Dementia Longitudinal method Neuropsychological tests Regression analysis Risk assessment T-test (Statistics) Phenotypes Independent living Proportional hazards models Walking speed sug: subj: Health status indicators Hypertension Old age Canada Dementia risk factors Geriatric assessment Chi-squared test Cognitive testing Comparative studies Confidence intervals Dementia Longitudinal method Neuropsychological tests Regression analysis Risk assessment T-test (Statistics) Phenotypes Independent living Proportional hazards models Walking speed keyword: cognition cohort study dementia dual decliners gait speed older people cognition cohort study dementia dual decliners gait speed older people ab: Background concurrent declines in gait speed and cognition have been associated with future dementia. However, the clinical profile of 'dual decliners', those with concomitant decline in both gait speed and cognition, has not been yet described. We aimed to describe the phenotype and the risk for incident dementia of those who present with dual decline in comparison with non-dual decliners. Methods prospective cohort of community-dwelling older adults free of dementia at baseline. We evaluated participants' gait speed, cognition, medical status, functionality, incidence of adverse events and dementia, biannually over 7 years. Gait speed was assessed with a 6-m electronic walkway and global cognition using the MoCA test. We compared characteristics between dual decliners and non-dual decliners using t -test, chi-square and hierarchical regression models. We estimated incident dementia using Cox models. Results among 144 participants (mean age 74.23 ± 6.72 years, 54% women), 17% progressed to dementia. Dual decliners had a 3-fold risk (HR: 3.12, 95%CI: 1.23–7.93, P = 0.017) of progression to dementia compared with non-dual decliners. Dual decliners were significantly older with a higher prevalence of hypertension and dyslipidemia (P = 0.002). Hierarchical regression models show that age and sex alone explained 3% of the variation in the dual decliners group. Adding hypertension and dyslipidemia increased the explained variation by 8 and 10%, respectively. The risk of becoming a dual decliner was 4-fold higher if hypertension was present. Conclusion older adults with a concurrent decline in gait speed and cognition represent a group at the highest risk of progression to dementia. Older adults with dual decline have a distinct phenotype with a higher prevalence of hypertension, a treatable condition. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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