Frederiksen Kristian Steen, Verdelho Ana, Madureira Sofia, Bäzner Hansjörg, O'Brien John T, Fazekas Franz, Scheltens Philip, Schmidt Reinhold, Wallin Anders, Wahlund Lars-Olof, Erkinjunttii Timo, Poggesi Anna, Pantoni Leonardo, Inzitari Domenico, Waldemar Gunhild
Memory Disorders Research Group, Danish Dementia Research Center, Department of Neurology, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Neurosciences, University of Lisbon, Santa Maria Hospital, Lisbon, Portugal.
Int J Geriatr Psychiatry. 2015 Jul;30(7):744-50. doi: 10.1002/gps.4220. Epub 2014 Nov 3.
Physical activity reduces the risk of cognitive decline but may affect cognitive domains differently. We examined whether physical activity modifies processing speed, executive function and memory in a population of non-dementia elderly subjects with age-related white matter changes (ARWMC).
Data from the Leukoaraiosis And DISability (LADIS) study, a multicenter, European prospective cohort study aimed at examining the role of ARWMC in transition to disability, was used. Subjects in the LADIS study were clinically assessed yearly for 3 years including MRI at baseline and 3-year follow-up. Physical activity was assessed at baseline, and cognitive compound scores at baseline and 3-year assessment were used.
Two-hundred-eighty-two subjects (age, y (mean (SD)): 73.1 (± 5.1); gender (f/m): 164/118); MMSE (mean (SD)): 28.3 (± 1.7)) who had not progressed to MCI or dementia, were included. Multiple variable linear regression analysis with baseline MMSE, education, gender, age, stroke, diabetes and ARWMC rating as covariates revealed that physical activity was associated with better scores at baseline and 3-year follow-up for executive function (baseline: β: 0.39, 95% CI: 0.13-0.90, p = 0.008; follow-up: β: 0.24, 95% CI: 0.10-0.38, p = 0.001) and processing speed (baseline: β: 0.48, 95% CI: 0.14-0.89, p = 0.005; follow-up: β: 0.15, 95% CI: 0.02-0.29, p = 0.02) but not memory. When including baseline cognitive score as a covariate in the analysis of 3-year follow-up scores, executive function remained significant (β: 0.11, 95% CI: 0-0.22, p = 0.04).
Our findings confirm previous findings of a positive effect of physical activity on cognitive functions in elderly subjects, and further extends these by showing that the association is also present in patients with ARWMC.
体育活动可降低认知能力下降的风险，但可能对不同认知领域产生不同影响。我们研究了体育活动是否会改变患有与年龄相关的白质病变（ARWMC）的非痴呆老年人群的处理速度、执行功能和记忆力。
使用了白质疏松症与残疾（LADIS）研究的数据，这是一项欧洲多中心前瞻性队列研究，旨在研究ARWMC在向残疾转变中的作用。LADIS研究中的受试者每年进行临床评估，为期3年，包括基线和3年随访时的MRI检查。在基线时评估体育活动情况，并使用基线和3年评估时的认知复合评分。
纳入了282名未进展为轻度认知障碍或痴呆的受试者（年龄，岁（均值（标准差））：73.1（±5.1）；性别（女/男）：164/118）；简易精神状态检查表（MMSE）（均值（标准差））：28.3（±1.7））。以基线MMSE、教育程度、性别、年龄、中风、糖尿病和ARWMC评级作为协变量的多变量线性回归分析显示，体育活动与执行功能在基线和3年随访时的更好评分相关（基线：β：0.39，95%置信区间：0.13 - 0.90，p = 0.008；随访：β：0.24，95%置信区间：0.10 - 0.38，p = 0.001）以及处理速度（基线：β：0.48，95%置信区间：0.14 - 0.89，p = 0.005；随访：β：0.15，95%置信区间：0.02 - 0.29，p = 0.02），但与记忆力无关。在对3年随访评分的分析中，将基线认知评分作为协变量纳入时，执行功能仍然显著（β：0.11，95%置信区间：0 - 0.22，p = 0.04）。
我们的研究结果证实了先前关于体育活动对老年受试者认知功能有积极影响的研究结果，并进一步扩展了这些结果，表明这种关联在患有ARWMC的患者中也存在。
