老年女性身体活动与认知衰退的前瞻性研究：步行的女性。

A prospective study of physical activity and cognitive decline in elderly women: women who walk.

作者信息

Yaffe K, Barnes D, Nevitt M, Lui L Y, Covinsky K

机构信息

University of California, San Francisco, Campus Box 111G, 4150 Clement St, San Francisco, CA 94121, USA.

出版信息

Arch Intern Med. 2001 Jul 23;161(14):1703-8. doi: 10.1001/archinte.161.14.1703.

DOI:10.1001/archinte.161.14.1703

PMID:11485502

Abstract

BACKGROUND

Several studies have suggested that physical activity is positively associated with cognitive function in elderly persons. Evidence about this association has been limited by the cross-sectional design of most studies and by the frequent lack of adjustment for potential confounding variables. We determined whether physical activity is associated with cognitive decline in a prospective study of older women.

METHODS

We studied 5925 predominantly white community-dwelling women (aged > or =65 years) who were recruited at 4 clinical centers and were without baseline cognitive impairment or physical limitations. We measured cognitive performance using a modified Mini-Mental State Examination at baseline and 6 to 8 years later. Physical activity was measured by self-reported blocks (1 block approximately 160 m) walked per week and by total kilocalories (energy) expended per week in recreation, blocks walked, and stairs climbed. Cognitive decline was defined as a 3-point decline or greater on repeated modified Mini-Mental State Examination.

RESULTS

Women with a greater physical activity level at baseline were less likely to experience cognitive decline during the 6 to 8 years of follow-up: cognitive decline occurred in 17%, 18%, 22%, and 24% of those in the highest, third, second, and lowest quartile of blocks walked per week (P< .001 for trend). Almost identical results were obtained by quartile of total kilocalories expended per week. After adjustment for age, educational level, comorbid conditions, smoking status, estrogen use, and functional limitation, women in the highest quartile remained less likely than women in the lowest quartile to develop cognitive decline (for blocks walked: odds ratio, 0.66 [95% confidence interval, 0.54-0.82]; for total kilocalories: odds ratio, 0.74 [95% confidence interval, 0.60-0.90]).

CONCLUSIONS

Women with higher levels of baseline physical activity were less likely to develop cognitive decline. This association was not explained by differences in baseline function or health status. This finding supports the hypothesis that physical activity prevents cognitive decline in older community-dwelling women.

摘要

背景

多项研究表明，身体活动与老年人的认知功能呈正相关。大多数研究的横断面设计以及对潜在混杂变量的频繁调整不足限制了有关这种关联的证据。我们在一项针对老年女性的前瞻性研究中确定身体活动是否与认知能力下降有关。

方法

我们研究了5925名主要为白人的社区居住女性（年龄≥65岁），她们在4个临床中心招募，且无基线认知障碍或身体限制。我们在基线时以及6至8年后使用改良的简易精神状态检查表测量认知表现。身体活动通过自我报告的每周步行街区数（1个街区约160米）以及每周在娱乐、步行街区和爬楼梯中消耗的总千卡数（能量）来衡量。认知能力下降定义为重复进行改良简易精神状态检查表时下降3分或更多。

结果

基线时身体活动水平较高的女性在6至8年的随访期间认知能力下降的可能性较小：每周步行街区数处于最高、第三、第二和最低四分位数的女性中，认知能力下降的发生率分别为17%、18%、22%和24%（趋势P<0.001）。按每周消耗的总千卡数的四分位数划分也得到了几乎相同的结果。在对年龄、教育水平、合并症、吸烟状况、雌激素使用和功能限制进行调整后，处于最高四分位数的女性比处于最低四分位数的女性发生认知能力下降的可能性仍然较小（对于步行街区数：比值比，0.66[95%置信区间，0.54 - 0.82]；对于总千卡数：比值比，0.74[95%置信区间，0.60 - 0.90]）。