Functional Charateristics Of Musculoskeletal Ambulation Disability Symptom Complex (mads) In Community-dwelling Older Women

Abstract

PURPOSE: For promoting the independence and prevention of falls of older adults, new category of motor disorders was established: musculoskeletal ambulation disability symptom complex (MADS). MADS is defined as an increased risk of falls and isolation due to an age-related decline in balance and walking ability. The purpose of this study was to understand functional charactertistics of MADS by examining the association among physical performance, cognitive functions and sedentary behavior in older community-dwellers in Japan. METHODS: Participants: 59 women aged 65 years and older (mean age 71 ± 4 yrs.) participated in this study. After the participants completed a demographic questionnaire, motor function assessments measurments, one-leg standing time with eyes open (OLS) and timed up-and-go test (TUG), were conducted as diagnostic criteria for MADS. Then, the participants were divided into two groups according to OLS time; G1: longer than 15 sec. and G2: less than 15 sec. Measurements: Following variables were measured; 1) physical function -- hand-grip strength, chair-stand, functional reach, gait speed (10 m), 2) cognitive function -- Mini-Mental State Examination (MMSE) and Trail Making Test-A (TMT-A), and 3) sedentary behavior -- self-reported questionnaire. Data are presented as means ± SD, and analyzed using unpaired t-test and ANCOVA. RESULTS: The average time of OLS was significantly different between G1 and G2 groups (61.3 ± 36.9 and 8.2 ± 3.6 sec., p<0.01). Age was significantly different between the G1 and G2 (70.3 ± 2.5 vs. 72.7 ± 3.2 yrs., p<0.05). The results show that maximal gate speed and TUG were significantly lower in G1 than G2 (1.82 ± 0.24 vs. 1.66 ± 0.25 m/sec., p<0.01) and (7.0 ± 1.1 vs. 8.0 ± 1.5 sec., p<0.05), respectively. In ANCOVA adjusting for the age, TMT-A and sedentary time were significantly different between G1 and G2; TMT-A : 93.9 ± 29.8 sec. vs. 103.3 ± 30.6 sec., p<0.01 and sedentary time: 8.8 ± 0.9 vs. 10.2 ± 1.5 hrs./day, p<0.05. MADS may affect the TMT-A and sedentary time in the older women. CONCLUSIONS: These results suggest that decline in physical and cognitive functions, and sedentary behavior may be significantly associated with the risk of MADS in older women. Follow up studies are necessary to examine physical and cognitive functions of older adults with and without MADS.