老年人客观测量的身体活动与认知功能
Objectively Measured Physical Activity and Cognitive Function in Older Adults.
作者信息
Zhu Wenfei, Wadley Virginia G, Howard Virginia J, Hutto Brent, Blair Steven N, Hooker Steven P
机构信息
1School of Physical Education, Shaanxi Normal University, Xi'an, Shaanxi, CHINA; 2Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL; 4Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC; 5Departments of Exercise Science and Epidemiology/Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC; and 6Exercise Science and Health Promotion Program, College of Health Solutions, Arizona State University, Phoenix, AZ.
出版信息
Med Sci Sports Exerc. 2017 Jan;49(1):47-53. doi: 10.1249/MSS.0000000000001079.
PURPOSE
Emerging evidence suggests physical activity (PA) is associated with cognitive function. To overcome limitations of self-report PA measures, this study investigated the association of accelerometer-measured PA with incident cognitive impairment and longitudinal cognition among older adults.
METHODS
Participants were recruited from the cohort study Reasons for Geographic and Racial Differences in Stroke in the United States. Accelerometers provided PA measures, including the percentage of total accelerometer wearing time spent in moderate-to-vigorous-intensity PA (MVPA%), light-intensity PA, and sedentary time for four to seven consecutive days at baseline. Cognitive impairment was defined by the Six-Item Screener. Letter fluency, animal fluency, word list learning, and Montreal Cognitive Assessment (orientation and recall) were conducted to assess executive function and memory.
RESULTS
Participants (N = 6452, 69.7 ± 8.5 yr, 55.3% women, 30.5% Black) with usable accelerometer and cognition measures spent extremely limited time in MVPA (1.5% ± 1.9% of accelerometer wearing time). During an average of 3 yr of follow-up, 346 cases of incident cognitive impairment were observed. After adjustments, participants in higher MVPA% quartiles had a lower risk of cognitive impairment (i.e., quartile 2: odds ratio = 0.64, 95% confidence interval = 0.48-0.84) and better maintenance in executive function (≥0.03 z-score units) and memory (≥0.12 z-score units) compared with quartile 1 (P < 0.05). Stratified analyses showed the same association among White adults, but higher MVPA% was associated with better maintenance of only memory among Black adults. No significance was found for light-intensity PA or sedentary time.
CONCLUSION
There was a dose-response relationship between MVPA% and cognitive function in older adults, with higher levels associated with a 36% or lower risk of cognitive impairment and better maintenance of memory and executive function over time, particularly in White adults.
目的
新出现的证据表明，身体活动（PA）与认知功能相关。为克服自我报告PA测量方法的局限性，本研究调查了通过加速度计测量的PA与老年人认知功能障碍发生率及纵向认知之间的关联。
方法
参与者来自美国中风地理和种族差异队列研究。加速度计提供PA测量数据，包括在基线时连续四至七天中度至剧烈强度PA（MVPA%）、轻度强度PA以及久坐时间在总加速度计佩戴时间中所占的百分比。认知功能障碍由六项筛查工具定义。进行字母流畅性、动物流畅性、单词列表学习以及蒙特利尔认知评估（定向和回忆）以评估执行功能和记忆。
结果
拥有可用加速度计和认知测量数据的参与者（N = 6452，69.7 ± 8.5岁，55.3%为女性，30.5%为黑人）在MVPA中花费的时间极少（占加速度计佩戴时间的1.5% ± 1.9%）。在平均3年的随访期间，观察到346例认知功能障碍新发病例。经过调整后，与第一四分位数相比，处于较高MVPA%四分位数的参与者发生认知功能障碍的风险较低（即第二四分位数：比值比 = 0.64，95%置信区间 = 0.48 - 0.84），并且在执行功能（≥0.03个z分数单位）和记忆（≥0.12个z分数单位）方面有更好的维持（P < 0.05）。分层分析显示，白人成年人中存在相同的关联，但较高的MVPA%仅与黑人成年人记忆的更好维持相关。在轻度强度PA或久坐时间方面未发现显著关联。
结论
老年人中MVPA%与认知功能之间存在剂量反应关系，较高水平与认知功能障碍风险降低36%或更低以及随着时间推移记忆和执行功能的更好维持相关，尤其是在白人成年人中。
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