âge et instabilité

TITLE:          Postural Instability Is Associated with Brain Atrophy and
                Cognitive Impairment in the Elderly: The J-SHIPP
Study (Article, English)
AUTHOR:         Kido, T; Tabara, Y; Igase, M; Ochi, N; Uetani, E; Nagai,
                T; Yamamoto, M; Taguchi, K; Miki, T; Kohara, K
SOURCE:         DEMENTIA AND GERIATRIC COGNITIVE DISORDERS 29 (5). 2010.
                p.379-387 KARGER, BASEL

SEARCH TERM(S):  GAIT  item_title,keyword,keyword_plus;
                 POSTUR*  item_title,keyword,keyword_plus;
                 BALANCE*  item_title,keyword,keyword_plus;
                 STABILIT*  item_title,keyword,keyword_plus;
                 STANDING  item_title,keyword,keyword_plus

KEYWORDS:       Postural stability; Brain atrophy; Cognitive decline; One-
                leg standing time
KEYWORDS+:       FUNCTIONING OLDER-ADULTS; TEMPORAL-LOBE ATROPHY; WHITE-
                MATTER CHANGES; ALZHEIMER-DISEASE; RISK-FACTORS; BLOOD-
                PRESSURE; FOLLOW-UP; PEOPLE; GAIT; MRI

ABSTRACT:       Background/Aims: Mobility impairment in older adults has
been suggested to be a marker of subclinical structural and functional
brain abnormalities. We investigated a possible association between
static postural instability and brain abnormalities and cognitive
decline. Methods: The study subjects were 390 community residents without
definitive dementia (67 +/- 7 years old) and 21 patients with Alzheimer's
disease (AD). Brain atrophy was measured by MRI. Results: The mobility of
the posturography-measured center of gravity (COG) was positively
associated with the temporal horn area (THA; r = 0.260; p < 0.001).
Subjects who could not stand on one leg for >40 s (n = 102) showed a
significantly larger THA (22 +/- 18 vs. 14 +/- 11 x 10(-2) cm(2); p <
0.001). Multiple regression analysis identified COG path length (beta =
0.118; p = 0.032) and one-leg standing time (beta = 0.176; p = 0.001) as
independent determinants of THA. Mild cognitive impairment (MCI) subjects
(n = 61) had a significantly enlarged THA compared to that of normal
cognitive subjects (22 8 16 vs. 16 +/- 13 x 10-(2) cm(2); p = 0.002). AD
patients showed a more enlarged THA (78 +/- 55 x 10(-2) cm(2)). Subjects
with cognitive decline showed a significantly shorter one-leg standing
time (normal: 50 +/- 17 s; MCI: 42 +/- 21 s; AD: 18 +/- 20s; p < 0.001).
Conclusion: Reduced postural stability was an independent marker of brain
atrophy and pathological cognitive decline in the elderly. Copyright (C)
2010 S. Karger AG, Basel

AUTHOR ADDRESS: Y Tabara, Ehime Univ, Grad Sch Med, Dept Basic Med Res &
                Educ, Toon City, Ehime 7910295, Japan

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