The value of gait markers other than gait speed in screening for sarcopenia with cognitive impairment
Objective Elderly patients with sarcopenia and cognitive impairment are prone to experiencing more severe adverse events.This study aimed to analyze body composition and gait characteristics in this population,as well as to identify sensitive gait indicators of sarcopenia in individuals with cognitive impairment.Methods A total of 200 elderly individuals from 3 different nursing homes in Suzhou were recruited for this study.The participants'overall cognitive function was assessed using the Beijing version of the Montreal Cognitive Assessment(MoCA-BJ),body composition was evaluated through bioelectrical impedance analysis,and gait was assessed using a wearable gait analysis system.Gait predictors of sarcopenia with cognitive impairment were then identified and used to construct predictive models.Results The study encompassed 83 participants,divided into three groups:35 in the control group(cognitively normal,without sarcopenia),24 in the sarcopenia with mild cognitive impairment(MCI)group,and 24 in the sarcopenia with dementia group.When compared to the control group,individuals in the sarcopenia with MCI group exhibited lower Skeletal Muscle Mass Index[(5.6±0.8)kg/m2 vs.(7.4±0.8)kg/m2],Total Protein[(6.7±1.1)kg vs.(8.9±1.5)kg],and Arm Muscle Circumference[(21.4±1.7)cm vs.(24.1±2.3)cm](all P＜0.05).Similarly,in comparison to the control group,those in the sarcopenia with dementia group displayed a shorter stride length[(0.45±0.17)m vs.(0.65±0.22)m],slower gait speed[(0.38±0.13)m/s vs.(0.55±0.18)m/s],smaller turn velocity[(89.8±23.4)degrees/s vs.(116.8±26.3)degrees/s],and longer turn duration[(3.2±0.5)s vs.(2.8±0.3)s](all P＜0.05).Notably,turn duration was identified as having predictive value for sarcopenia with MCI[Area under the curve(AUC)=0.673,sensitivity 70.8％,specificity 68.6％],while a model incorporating age and turn velocity demonstrated strong predictive power for sarcopenia with dementia(AUC=0.87,sensitivity 83.3％,specificity 85.7％).Conclusions Compared to the control group,the group with both sarcopenia and cognitive impairment exhibited lower levels of muscle strength,nutritional status,and gait performance.This study also introduced the concept that gait indicators associated with turns could be a significant predictor of sarcopenia in individuals with cognitive impairment.Furthermore,the use of wearable devices for gait assessment may offer a novel approach to identifying these at-risk individuals.
万方数据
维普
