Yao Hiroshi, Takashima Yuki, Araki Yuko, Uchino Akira, Yuzuriha Takefumi, Hashimoto Manabu
Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Saga, Japan.
Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Saga, Japan.
J Stroke Cerebrovasc Dis. 2015 Nov;24(11):2625-31. doi: 10.1016/j.jstrokecerebrovasdis.2015.07.018. Epub 2015 Aug 20.
Although physical inactivity is a major public health problem, the causative factors for physical inactivity per se are poorly understood. To address this issue, we investigated the relationship between deep white matter lesions (DWMLs) on magnetic resonance imaging, apathy, and physical activities using structural equation modeling (SEM).
We examined 317 community-dwelling elderly subjects (137 men and 180 women with a mean age of 64.5 years) without dementia or clinically apparent depression. Physical activity was assessed with a questionnaire consisting of 3 components (leisure-time, work, and sport activities).
The mean score from the apathy scale (a visual analogue version of Starkstein's apathy scale) of the Grades 2-3 DWML group was 420 (95% confidence interval [CI] 379-461), which was lower (more apathetic) than the Grade 0 DWML group score of 478 (95% CI 463-492) after adjustment for education as a covariate. SEM showed that the direct paths from DWMLs or education to apathy were significant, and the direct path from apathy to leisure-time activity was highly significant (β = .25, P < .001). The degree of apathetic behavior was negatively associated with sport activity in female subjects and positively associated with TV watching in male subjects.
The results of the study show that DWMLs are one of the major factors that cause apathetic behavior and that apathy has significant negative effects on leisure-time physical activity in community-dwelling elderly subjects. Even a minor level of apathy without major depression would have a significant impact on activities of daily living and quality of life.
尽管缺乏身体活动是一个主要的公共卫生问题，但对于缺乏身体活动本身的致病因素却知之甚少。为了解决这个问题，我们使用结构方程模型（SEM）研究了磁共振成像上的深部白质病变（DWMLs）、冷漠与身体活动之间的关系。
我们检查了317名居住在社区的老年受试者（137名男性和180名女性，平均年龄64.5岁），这些受试者没有痴呆或临床上明显的抑郁症状。使用由三个部分（休闲时间、工作和体育活动）组成的问卷评估身体活动。
2-3级DWML组的冷漠量表（Starkstein冷漠量表的视觉模拟版本）平均得分是420（95%置信区间[CI]379-461），在将教育作为协变量进行调整后，该得分低于0级DWML组的478（95%CI 463-492）（更冷漠）。SEM显示，从DWMLs或教育到冷漠的直接路径是显著的，从冷漠到休闲时间活动的直接路径非常显著（β = 0.25，P < 0.001）。冷漠行为的程度在女性受试者中与体育活动呈负相关，在男性受试者中与看电视呈正相关。
研究结果表明，DWMLs是导致冷漠行为的主要因素之一，并且冷漠对居住在社区的老年受试者的休闲时间身体活动有显著的负面影响。即使是没有严重抑郁的轻微冷漠水平也会对日常生活活动和生活质量产生重大影响。
