脑灌注与各收缩压水平和年龄下的步态速度的关系：一项队列研究。
Relationships of Cerebral Perfusion With Gait Speed Across Systolic Blood Pressure Levels and Age: A Cohort Study.
机构信息
Department of Medicine/Geriatrics, The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA.
出版信息
J Gerontol A Biol Sci Med Sci. 2023 Mar 1;78(3):514-520. doi: 10.1093/gerona/glac120.
BACKGROUND
This study aimed to examine if the association of cerebral perfusion with gait speed differs across systolic blood pressure (SBP) and age.
METHODS
Cerebral perfusion was measured via arterial spin labeled (ASL)-MRI among community-dwelling adults aged 31-94 years in the population-based Mayo Clinic Study of Aging. Usual gait speed was assessed over 5.6 meters on an electronic mat. Sex- and body mass index (BMI)-adjusted linear regression models estimated cross-sectional gait speed associations with ASL and modifying effects of age and SBP using 3-way and 2-way interaction terms between continuous age, SBP, and ASL. Results report estimated differences in gait speed per standard deviation (SD) lower ASL for exemplar SBPs and ages.
RESULTS
Among 479 participants (mean age 67.6 years; 44% women; mean gait speed 1.17 m/s), ASL relations to gait speed varied by age (ASL-x-age interaction: p = .001) and SBP (ASL-x-SBP interaction: p = .009). At an SBP of 120 mmHg, each SD lower ASL was associated with a 0.04 m/s (95% confidence interval [CI]: 0.01, 0.07) slower gait speed at 65 years, 0.07 m/s (0.04, 0.10) at 75 years, and 0.09 m/s (0.05, 0.13) at 85 years. At an SBP of 140 mmHg, ASL associations with gait speed were attenuated to 0.01 (-0.01, 0.04), 0.04 (0.02, 0.06), and 0.06 (0.04, 0.09) m/s slower gait speed at ages 65, 75, and 85, respectively.
CONCLUSION
Poorer cerebral perfusion is associated with clinically meaningful slower gait speeds, particularly with older age, while higher perfusion markedly attenuates age differences in gait speed.
背景
本研究旨在探讨大脑灌注与步态速度的关联是否因收缩压（SBP）和年龄而异。
方法
在基于人群的梅奥诊所老龄化研究中，对 31-94 岁的社区居住成年人进行动脉自旋标记（ASL）-MRI 测量大脑灌注。使用电子垫评估 5.6 米的常规步态速度。使用 3 路和 2 路交叉项，在性别和体重指数（BMI）调整后的线性回归模型中，估计 ASL 与横断面步态速度的关联，以及年龄和 SBP 的调节作用。结果报告了每个 ASL 标准偏差（SD）降低的情况下，为典型 SBP 和年龄的步态速度差异的估计值。
结果
在 479 名参与者中（平均年龄 67.6 岁；44%为女性；平均步态速度为 1.17 m/s），ASL 与步态速度的关系因年龄（ASL-x-age 交互作用：p =.001）和 SBP（ASL-x-SBP 交互作用：p =.009）而异。在 SBP 为 120 mmHg 时，每个 ASL 降低 1 SD 与 65 岁时的步态速度降低 0.04 m/s（95%置信区间[CI]：0.01，0.07）、75 岁时的 0.07 m/s（0.04，0.10）和 85 岁时的 0.09 m/s（0.05，0.13）相关。在 SBP 为 140 mmHg 时，ASL 与步态速度的关联减弱至 0.01（-0.01，0.04）、0.04（0.02，0.06）和 0.06（0.04，0.09）m/s，与 65、75 和 85 岁的步态速度较慢相关。
结论
较差的大脑灌注与临床上明显较慢的步态速度相关，尤其是与年龄较大有关，而较高的灌注则明显减轻了年龄对步态速度的差异。
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