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老年人的身体活动与新发认知障碍:INVADE研究

Physical activity and incident cognitive impairment in elderly persons: the INVADE study.

作者信息

Etgen Thorleif, Sander Dirk, Huntgeburth Ulrich, Poppert Holger, Förstl Hans, Bickel Horst

机构信息

Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany.

出版信息

Arch Intern Med. 2010 Jan 25;170(2):186-93. doi: 10.1001/archinternmed.2009.498.

Abstract

BACKGROUND

Data regarding the relationship between physical activity and cognitive impairment are limited and controversial. We examined whether physical activity is associated with incident cognitive impairment during follow-up.

METHODS

As part of a community-based prospective cohort study in southern Bavaria, Germany, 3903 participants older than 55 years were enrolled between 2001 and 2003 and followed up for 2 years. Physical activity (classified as no activity, moderate activity [<3 times/wk], and high activity [> or =3 times/wk]), cognitive function (assessed by the 6-Item Cognitive Impairment Test), and potential confounders were evaluated. The main outcome measure was incident cognitive impairment after 2 years of follow-up.

RESULTS

At baseline, 418 participants (10.7%) had cognitive impairment. After a 2-year follow-up, 207 of 3485 initially unimpaired subjects (5.9%) developed incident cognitive impairment. Compared with participants without physical activity, fully adjusted multiple logistic regression analysis showed a significantly reduced risk of incident cognitive impairment after 2 years for participants with moderate or high physical activity at baseline (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.37-0.87 [P = .01]; and OR, 0.54; 95% CI, 0.35-0.83 [P = .005]; respectively). Further subanalysis including participants (n = 2029) without functional impairment and without prodromal phase of dementia resulted in an even higher reduction of risk of incident cognitive impairment for participants with moderate or high physical activity (OR, 0.44; 95% CI, 0.24-0.83 [P = .01]; and OR, 0.46; 95% CI, 0.25-0.85 [P = .01]; respectively) compared with no activity.

CONCLUSION

Moderate or high physical activity is associated with a reduced incidence of cognitive impairment after 2 years in a large population-based cohort of elderly subjects.

摘要

背景

关于身体活动与认知障碍之间关系的数据有限且存在争议。我们研究了在随访期间身体活动是否与新发认知障碍相关。

方法

作为德国巴伐利亚南部一项基于社区的前瞻性队列研究的一部分,2001年至2003年招募了3903名55岁以上的参与者,并随访2年。评估了身体活动(分为无活动、中等活动[<每周3次]和高强度活动[≥每周3次])、认知功能(通过6项认知障碍测试评估)以及潜在混杂因素。主要结局指标是随访2年后的新发认知障碍。

结果

在基线时,418名参与者(10.7%)有认知障碍。经过2年随访,3485名最初无认知障碍的受试者中有207名(5.9%)出现了新发认知障碍。与无身体活动的参与者相比,完全调整后的多因素逻辑回归分析显示,基线时进行中等或高强度身体活动的参与者在2年后新发认知障碍的风险显著降低(优势比[OR]分别为0.57;95%置信区间[CI]为0.37 - 0.87[P = 0.01];以及OR为0.54;95%CI为0.35 - 0.83[P = 0.005])。进一步的亚组分析纳入了无功能障碍且无痴呆前驱期的参与者(n = 2029),结果显示与无活动相比,进行中等或高强度身体活动的参与者新发认知障碍的风险降低幅度更大(OR分别为0.44;95%CI为0.24 - 0.83[P = 0.01];以及OR为0.46;95%CI为0.25 - 0.85[P = 0.01])。

结论

在一个基于人群的大型老年队列中,中等或高强度身体活动与2年后认知障碍发病率降低相关。

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