Should Slowing Be Considered a Distinct Geriatric Syndrome?

The impact of sociodemographic and health aspects on cognitive performance in the older adult population in the republic of Serbia

The aim of this study was to investigate how sociodemographic and health factors contribute cognitive abilities in the older population of the Republic of Serbia, using data from the 2019 national health survey. The study included 3,743 participants, of whom 2,061 (55.1%) were women and 1,682 (44.9%) were men. The median age of all participants was 72 (10) years. Study used logistic regression on cross-sectional data to analyze how education, social support, and healthcare access affect cognitive abilities, while adjusting for demographic variables. The results revealed negative associations between higher levels of education and lower odds of experiencing memory and concentration problems, while recent visits to specialists were positively associated with increased risk for the same. The highest percentage of participants (22.6%) reporting major difficulties in memory and concentration were in the age group of 85-89 years (p < 0.001). A statistically significant relationship was found between social support and issues related to memory and concentration (p < 0.001). Social support emerged as a significant factor in preserving cognitive abilities. The discussion underscores the need for a comprehensive approach in promoting cognitive health, taking into account education, social integration, and access to healthcare as key factors. The study acknowledges its limitations, including its cross-sectional nature and potential subjective biases in self-assessment of cognitive abilities. Future research should incorporate longitudinal studies and more objective measures of cognitive abilities.

Impact of White Matter Hyperintensity and Age on Gait Parameters in Patients With Cerebral Small Vessel Disease

OBJECTIVES

This study aimed to investigate the effect of white matter hyperintensity (WMH), a common cerebral small vessel disease (CSVD) imaging marker, and age on gait parameters in middle-aged and geriatric populations.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

A total of 1076 participants (62.9% female; age 61.0 ± 9.3 years), who visited the neurology clinic or obtained a physical check-up from the Affiliated Hospital of Guizhou Medical University. In total, 883 patients with WMH and 193 healthy controls were included in this study.

METHODS

The Fazekas scores of patients with CSVD were used to assess the burden of WMH. Based on the Fazekas scores, all participants were divided into 4 groups: 553 patients with Fazekas I, 257 patients with Fazekas II, 73 patients with Fazekas III, and 193 controls. Gait parameters, including step speed, frequency, length, width, stance time, and swing time, were quantitatively assessed using a vision-based artificial intelligence gait analyzer (SAIL system). The relationships among the Fazekas scores, age, and gait parameters were analyzed.

RESULTS

Step speed, step length, step width, stance time, and swing time were significantly different among the 4 groups. Furthermore, Fazekas scores and age were both associated with gait parameters, including step speed, step length, stance time, and swing time. The Fazekas scores were associated with step width, whereas age was not. Age was associated with step frequency, whereas Fazekas scores were not.

CONCLUSIONS AND IMPLICATIONS

Fazekas score and age are useful for evaluating gait parameters in patients with CSVD. Emerging WMH (such as Fazekas Ⅰ) could be a clinical warning sign of gait disturbance in a geriatric population.

Slowness as a Predictor of Functional Decline in Older Adults: Comparison of Moberg Picking-Up Test and Walking Speed

OBJECTIVES

Slowness, generally assessed by walking speed (WS), is an estimator of frailty and its outcomes. Because of potential difficulties in assessing WS, the Moberg picking-up test (MPUT) might be an alternative. This study investigated the capacity of slowness measurements (WS and MPUT) to predict nonfatal adverse consequences of frailty: primarily, decline in basic activities of daily living (BADL); and secondarily, decline in instrumental activities of daily living (IADL), fall, hospitalization, and incident disease.

DESIGN

Observational (prospective longitudinal study).

SETTING AND PARTICIPANTS

This study used data from the population-based Lausanne cohort 65+. At baseline, 1887 individuals (aged 72-77 years) completed both WS (time to walk 20 m at usual pace) and MPUT (time to pick up 12 objects) assessments.

METHODS

All outcomes, assessed at 1- and 4-year follow-ups, were entered in separate logistic regression models with adjustment for age, sex, and respective values at baseline. The prediction of all outcomes by either WS or MPUT was assessed using area under the receiver operating characteristic curve and compared by χ² tests.

RESULTS

There were positive associations between slowness either assessed by WS [relative risk (RR) = 2.48; P < .001] or MPUT (RR = 1.91; P < .001) and decline in BADL at 1-year follow-up. These associations remained significant at 4-year follow-up for both WS (RR = 2.28; P < .001) and MPUT (RR = 1.95; P < .001). There was no significant difference between predictive values of slow WS and MPUT for decline in BADL at 1-year (P = .328) and 4-year follow-ups (P = .413). The prediction was not significantly different for secondary outcomes, except for decline in IADL for which the prediction was slightly better for WS.

CONCLUSIONS AND IMPLICATIONS

MPUT may be an alternative measurement of slowness with predictive value of functional decline. No significant difference in predictive capabilities of MPUT and WS for specific adverse consequences of frailty is promising in favor of using MPUT for measuring slowness.