Nakahara K1, Takano Y2
1Kumamoto Health Science University, Rehabilitation, Kumamoto, Japan, 2International University of Health and Welfare, School of Health Sciences at Fukuoka, Okawa, Japan
Background: Since the prevalence of dementia increases with age, it is estimated that by 2025 the proportion of people over age 65 with dementia will be 25.8% in Japan. Therefore, early detection of declining cognitive function and appropriate intervention are important public health concerns in Japan.
Purpose: We classified community-dwelling elderly women into two groups, a mild cognitive impairment (MCI) group and non-MCI group, based on Mini-Mental State Examination (MMSE) scores. We then attempted to extract evaluation items that would allow us to identify older individuals with MCI early in the community.
Methods: Participants comprised 143 community-dwelling women age 65 or older who do not regularly exercise. Individuals who scored 23 points or less on the MMSE were excluded. Fall risk was scored using a fall assessment questionnaire reported by Suzuki et al. We evaluated the Trail Making Test part A (TMT-A) and physical function (grip strength, one-leg standing test with eyes open, chair stand test, and Timed Up-and-Go (TUG) test). We then classified participants into the MCI group (n=96) and the non-MCI group (n=44), compared the results of their assessments using the unpaired t-test, Mann-Whitney U test, and χ2 test, and performed multivariate logistic regression analysis using the stepwise method. The measurement items other than fall risk assessment were each divided into low and high groups with the median score as the cutoff.
Results: The MCI group had significantly higher age (p 0.001), lower grip strength (p 0.001), and worse scores on the chair stand test, TUG test, TUG manual test obtained by adding the problem carrying glass containing the water TUG test in order to assess the dual task performance ability, and TMT-A (p 0.001) than the non-MCI group. Fall risk in the MCI group was significantly higher than the non-MCI group for items including becoming dizzy upon standing, history of stroke, and fear of falling (p=0.03, 0.02, and 0.001, respectively). According to the results of logistic regression analysis adjusted for age using the stepwise method, the odds ratio (OR) of MCI was 3.36 (95%CI 1.49-7.57) for those who took longer than 7.35 seconds on the chair stand test, and was 3.04 (95%CI 1.31-7.11) for those who took longer than 49.59 seconds on the TMT-A. The OR was 4.94 (95%CI 1.31-18.68) for those who became dizzy upon standing, and was 5.16 (95%CI 1.45-18.33) for those with a fear of falling.
Conclusion(s): This study targeted older community-dwelling people who do not exercise regularly. Although the prevalence of MCI in the present study was higher than that in the previous study, the results suggest that we may be able to screen for high risk of MCI using physical function tests as well as cognitive function tests.
Implications: Older people can be screened for MCI by physical function tests and a questionnaire about fall risk. Therefore, this screening may be useful during the community-based exercise classes.
Keywords: community-dwelling older people, MCI, physical function
Funding acknowledgements: This study was supported by KAKENHI Grant Number 25870528.
Purpose: We classified community-dwelling elderly women into two groups, a mild cognitive impairment (MCI) group and non-MCI group, based on Mini-Mental State Examination (MMSE) scores. We then attempted to extract evaluation items that would allow us to identify older individuals with MCI early in the community.
Methods: Participants comprised 143 community-dwelling women age 65 or older who do not regularly exercise. Individuals who scored 23 points or less on the MMSE were excluded. Fall risk was scored using a fall assessment questionnaire reported by Suzuki et al. We evaluated the Trail Making Test part A (TMT-A) and physical function (grip strength, one-leg standing test with eyes open, chair stand test, and Timed Up-and-Go (TUG) test). We then classified participants into the MCI group (n=96) and the non-MCI group (n=44), compared the results of their assessments using the unpaired t-test, Mann-Whitney U test, and χ2 test, and performed multivariate logistic regression analysis using the stepwise method. The measurement items other than fall risk assessment were each divided into low and high groups with the median score as the cutoff.
Results: The MCI group had significantly higher age (p 0.001), lower grip strength (p 0.001), and worse scores on the chair stand test, TUG test, TUG manual test obtained by adding the problem carrying glass containing the water TUG test in order to assess the dual task performance ability, and TMT-A (p 0.001) than the non-MCI group. Fall risk in the MCI group was significantly higher than the non-MCI group for items including becoming dizzy upon standing, history of stroke, and fear of falling (p=0.03, 0.02, and 0.001, respectively). According to the results of logistic regression analysis adjusted for age using the stepwise method, the odds ratio (OR) of MCI was 3.36 (95%CI 1.49-7.57) for those who took longer than 7.35 seconds on the chair stand test, and was 3.04 (95%CI 1.31-7.11) for those who took longer than 49.59 seconds on the TMT-A. The OR was 4.94 (95%CI 1.31-18.68) for those who became dizzy upon standing, and was 5.16 (95%CI 1.45-18.33) for those with a fear of falling.
Conclusion(s): This study targeted older community-dwelling people who do not exercise regularly. Although the prevalence of MCI in the present study was higher than that in the previous study, the results suggest that we may be able to screen for high risk of MCI using physical function tests as well as cognitive function tests.
Implications: Older people can be screened for MCI by physical function tests and a questionnaire about fall risk. Therefore, this screening may be useful during the community-based exercise classes.
Keywords: community-dwelling older people, MCI, physical function
Funding acknowledgements: This study was supported by KAKENHI Grant Number 25870528.
Topic: Older people; Health promotion & wellbeing/healthy ageing; Outcome measurement
Ethics approval required: Yes
Institution: Nagasaki University
Ethics committee: Graduate School of Biomedical Sciences
Ethics number: 13092657
All authors, affiliations and abstracts have been published as submitted.
