Lee Allen T C, Richards Marcus, Chan Wai C, Chiu Helen F K, Lee Ruby S Y, Lam Linda C W
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
MRC Unit for Lifelong Health and Ageing at University College London, London, United Kingdom.
J Am Med Dir Assoc. 2015 Oct 1;16(10):899.e1-7. doi: 10.1016/j.jamda.2015.07.012.
To systematically examine the amount and type of physical exercise that might reduce the future risk of dementia in community-living older people.
Six-year observational study.
All the Elderly Health Centers (EHCs) of the Department of Health in Hong Kong.
A total of 15,589 community-living Chinese aged 65 years and older with no history of stroke, clinical dementia, or Parkinson disease when they completed health assessment at the EHCs in the first 6 months of 2005.
Self-reported habitual physical exercise patterns, including the frequency, duration, and type of exercise, at baseline and Year 3 were analyzed. The study outcome was incident dementia in 6 years. Dementia was defined by presence of clinical dementia in accordance with the 10th revision of the International Statistical Classification of Diseases and Related Health Problems or Clinical Dementia Rating of 1 to 3.
Both the cognitively stable and incident groups reported exercising a median of 7 days per week and 45 minutes per day at baseline and Year 3. The former practiced aerobic and mind-body exercises more at baseline and Year 3, whereas the latter practiced stretching and toning exercises more. The odds ratio for dementia remained significant for aerobic (0.81; 95% confidence interval 0.68-0.95; P = .01) and mind-body exercises (0.76; 0.63-0.92; P = .004) after excluding participants who developed dementia within 3 years after baseline and adjusting for important potential confounders, such as age, gender, educational level, and physical and psychiatric comorbidities.
Although physical exercise is widely promoted as a nonpharmacological intervention for dementia prevention, not all types of exercise appear to be useful in reducing risk of dementia in older people. Our findings suggest that daily participation in aerobic and mind-body but not stretching and toning exercises might protect community-living older adults from developing dementia.
系统研究何种运动量及运动类型可能降低社区居住老年人未来患痴呆症的风险。
为期六年的观察性研究。
香港卫生署所有的老人健康中心。
2005年前6个月在老人健康中心完成健康评估时，共有15589名65岁及以上、无中风、临床痴呆或帕金森病病史的社区居住中国老人。
分析基线期和第3年时自我报告的习惯性体育锻炼模式，包括锻炼频率、时长和类型。研究结局为6年内发生痴呆症。痴呆症根据《国际疾病和相关健康问题统计分类》第10版中的临床痴呆症诊断标准或临床痴呆评定量表评分为1至3分来定义。
认知功能稳定组和发病组在基线期和第3年时均报告每周平均锻炼7天，每天锻炼45分钟。前者在基线期和第3年时更多地进行有氧运动和身心锻炼，而后者更多地进行伸展和塑形锻炼。在排除基线期后3年内发生痴呆症的参与者，并对年龄、性别、教育水平以及身体和精神合并症等重要潜在混杂因素进行调整后发现，有氧运动（比值比为0.81；95%置信区间为0.68 - 0.95；P = 0.01）和身心锻炼（比值比为0.76；0.63 - 0.92；P = 0.004）预防痴呆症的效果仍具有统计学意义。
尽管体育锻炼作为预防痴呆症的非药物干预措施得到广泛推广，但并非所有类型的锻炼似乎都有助于降低老年人患痴呆症的风险。我们的研究结果表明，每天进行有氧运动和身心锻炼而非伸展和塑形锻炼，可能会保护社区居住的老年人不患痴呆症。
