Wilson R S, Bennett D A, Bienias J L, Aggarwal N T, Mendes De Leon C F, Morris M C, Schneider J A, Evans D A
Department of Neurological Sciences, Rush Alzheimer's Disease Center and Rush Institute for Healthy Aging, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.
Neurology. 2002 Dec 24;59(12):1910-4. doi: 10.1212/01.wnl.0000036905.59156.a1.
Participation in cognitively stimulating activities is hypothesized to be associated with risk of AD, but knowledge about this association is limited.
A biracial community in Chicago was censused, persons aged 65 years and older were asked to participate in an interview, and 6,158 of 7,826 (79%) eligible persons did so. As part of the interview, persons rated current frequency of participation in seven cognitive activities (e.g., reading a newspaper) and nine physical activities (e.g., walking for exercise) from which composite measures of cognitive and physical activity frequency were derived. Four years later, 1,249 of those judged free of AD were sampled for a detailed clinical evaluation of incident disease and 842 (74% of those eligible) participated.
The composite measure of cognitive activity ranged from 1.28 to 4.71 (mean 3.30; SD 0.59), with higher scores indicating more frequent activity. A total of 139 persons met National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for AD on clinical evaluation. In a logistic regression model adjusted for age, education, sex, race, and possession of the APOE epsilon4 allele, a one-point increase in cognitive activity score was associated with a 64% reduction in risk of incident AD (OR 0.36; 95% CI 0.20 to 0.65). By contrast, weekly hours of physical activity (mean 3.5; SD 5.1) was not related to disease risk (OR 1.04; 95% CI 0.98 to 1.10). Education was associated with risk of AD and a similar trend was present for occupation, but these effects were substantially reduced when cognitive activity was added to the model.
Frequency of participation in cognitively stimulating activities appears to be associated with risk of AD and may partially explain the association of educational and occupational attainment with disease risk.
据推测，参与认知刺激活动与患阿尔茨海默病（AD）的风险相关，但关于这种关联的了解有限。
对芝加哥一个双种族社区进行了人口普查，邀请65岁及以上的人参加访谈，7826名符合条件的人中，有6158人（79%）参与了访谈。作为访谈的一部分，人们对当前参与七种认知活动（如读报纸）和九种体育活动（如散步锻炼）的频率进行评分，由此得出认知和体育活动频率的综合指标。四年后，从那些被判定无AD的人中抽取1249人进行新发疾病的详细临床评估，842人（74%符合条件者）参与了评估。
认知活动的综合指标范围为1.28至4.71（平均3.30；标准差0.59），分数越高表明活动越频繁。在临床评估中，共有139人符合美国国立神经疾病和中风研究所-阿尔茨海默病及相关疾病协会的AD标准。在调整了年龄、教育程度、性别、种族和携带APOE ε4等位基因的逻辑回归模型中，认知活动得分每增加一分，新发AD风险降低64%（比值比0.36；95%置信区间0.20至0.65）。相比之下，每周体育活动时间（平均3.5；标准差5.1）与疾病风险无关（比值比1.04；95%置信区间0.98至1.10）。教育程度与AD风险相关，职业也有类似趋势，但在模型中加入认知活动后，这些影响大幅降低。
参与认知刺激活动的频率似乎与AD风险相关，可能部分解释了教育程度和职业成就与疾病风险的关联。
