中年人心血管呼吸适能与认知功能：神经保护还是神经选择？
Cardiorespiratory fitness and cognitive function in midlife: neuroprotection or neuroselection?
作者信息
Belsky Daniel W, Caspi Avshalom, Israel Salomon, Blumenthal James A, Poulton Richie, Moffitt Terrie E
机构信息
Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC; Social Science Research Institute, Duke University, Durham, NC.
出版信息
Ann Neurol. 2015 Apr;77(4):607-17. doi: 10.1002/ana.24356. Epub 2015 Mar 6.
OBJECTIVE
A study was undertaken to determine whether better cognitive functioning at midlife among more physically fit individuals reflects neuroprotection, by which fitness protects against age-related cognitive decline, or neuroselection, by which children with higher cognitive functioning select more active lifestyles.
METHODS
Children in the Dunedin Longitudinal Study (N = 1,037) completed the Wechsler Intelligence Scales and the Trail Making, Rey Delayed Recall, and Grooved Pegboard tasks as children and again at midlife (age = 38 years). Adult cardiorespiratory fitness was assessed using a submaximal exercise test to estimate maximum oxygen consumption adjusted for body weight in milliliters/minute/kilogram. We tested whether more fit individuals had better cognitive functioning than their less fit counterparts (which could be consistent with neuroprotection), and whether better childhood cognitive functioning predisposed to better adult cardiorespiratory fitness (neuroselection). Finally, we examined possible mechanisms of neuroselection.
RESULTS
Participants with better cardiorespiratory fitness had higher cognitive test scores at midlife. However, fitness-associated advantages in cognitive functioning were already present in childhood. After accounting for childhood baseline performance on the same cognitive tests, there was no association between cardiorespiratory fitness and midlife cognitive functioning. Socioeconomic and health advantages in childhood and healthier lifestyles during young adulthood explained most of the association between childhood cognitive functioning and adult cardiorespiratory fitness.
INTERPRETATION
We found no evidence for a neuroprotective effect of cardiorespiratory fitness as of midlife. Instead, children with better cognitive functioning are selecting healthier lives. Fitness interventions may enhance cognitive functioning. However, observational and experimental studies testing neuroprotective effects of physical fitness should consider confounding by neuroselection.
目的
开展一项研究以确定，在中年时身体更健康的个体中，更好的认知功能反映的是神经保护作用（即健康状况可预防与年龄相关的认知衰退）还是神经选择作用（即认知功能较高的儿童选择更积极的生活方式）。
方法
达尼丁纵向研究中的儿童（N = 1037）在儿童期以及中年时（年龄 = 38岁）分别完成了韦氏智力量表、连线测验、雷伊延迟回忆测验和沟槽钉板测验。使用次极量运动试验评估成年人心肺适能，以估计经体重校正后的最大耗氧量，单位为毫升/分钟/千克。我们测试了身体更健康的个体是否比身体不太健康的个体具有更好的认知功能（这可能符合神经保护作用），以及儿童期更好的认知功能是否会使成年人心肺适能更好（神经选择作用）。最后，我们研究了神经选择作用的可能机制。
结果
心肺适能较好的参与者在中年时认知测试得分更高。然而，与健康状况相关的认知功能优势在儿童期就已存在。在考虑了儿童期在相同认知测试中的基线表现后，心肺适能与中年认知功能之间没有关联。儿童期的社会经济和健康优势以及成年早期更健康的生活方式解释了儿童期认知功能与成年人心肺适能之间的大部分关联。
解读
我们没有发现截至中年时心肺适能具有神经保护作用的证据。相反，认知功能较好的儿童正在选择更健康的生活。健身干预可能会增强认知功能。然而，测试体能神经保护作用的观察性和实验性研究应考虑神经选择作用造成的混杂因素。
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