Krell-Roesch Janina, Pink Anna, Roberts Rosebud O, Stokin Gorazd B, Mielke Michelle M, Spangehl Kathleen A, Bartley Mairead M, Knopman David S, Christianson Teresa J H, Petersen Ronald C, Geda Yonas E
Translational Neuroscience and Aging Program, Mayo Clinic, Scottsdale, Arizona.
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
J Am Geriatr Soc. 2016 Dec;64(12):2479-2486. doi: 10.1111/jgs.14402. Epub 2016 Nov 1.
To investigate the timing (mid- vs late life) of physical activity, apolipoprotein (APO)E ε4, and risk of incident mild cognitive impairment (MCI).
Prospective cohort study.
Mayo Clinic Study of Aging (Olmsted County, MN).
Cognitively normal elderly adults (N = 1,830, median age 78, 50.2% female).
Light, moderate, and vigorous physical activities in mid- and late life were assessed using a validated questionnaire. An expert consensus panel measured MCI based on published criteria. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) with age as a time scale after adjusting for sex, education, medical comorbidity, and depression.
Light (HR = 0.58, 95% CI = 0.43-0.79) and vigorous (HR = 0.78, 95% CI = 0.63-0.97) physical activity in midlife were associated with lower risk of incident MCI. The association between moderate activity and incident MCI was not significant (HR = 0.85, 95% CI = 0.67-1.09). In late life, light (HR = 0.75, 95% CI = 0.58-0.97) and moderate (HR = 0.81, 95% CI = 0.66-0.99) but not vigorous physical activity were associated with lower risk of incident MCI. A synergistic interaction was also observed between mid- and late-life activity in reducing risk of incident MCI. Furthermore, APOE ε4 carriers who did not exercise had a higher risk of incident MCI than noncarriers who reported physical activity.
Physical activity reduced the risk of incident MCI. Exercising in mid- and late life had an additive synergistic interaction in reducing the risk of MCI.
研究体力活动的时间（中年与老年）、载脂蛋白（APO）Eε4与轻度认知障碍（MCI）发病风险之间的关系。
前瞻性队列研究。
梅奥诊所衰老研究（明尼苏达州奥尔姆斯特德县）。
认知功能正常的老年人（N = 1830，中位年龄78岁，女性占50.2%）。
使用经过验证的问卷评估中年和老年时期的轻度、中度和剧烈体力活动。一个专家共识小组根据已发表的标准对MCI进行评估。在调整了性别、教育程度、合并症和抑郁因素后，使用Cox比例风险模型以年龄作为时间尺度计算风险比（HR）和95%置信区间（CI）。
中年时期的轻度体力活动（HR = 0.58，95%CI = 0.43 - 0.79）和剧烈体力活动（HR = 0.78，95%CI = 0.63 - 0.97）与MCI发病风险较低相关。中度体力活动与MCI发病之间的关联不显著（HR = 0.85，95%CI = 0.67 - 1.09）。在老年时期，轻度体力活动（HR = 0.75，95%CI = 0.58 - 0.97）和中度体力活动（HR = 0.81，95%CI = 0.66 - 0.99）与MCI发病风险较低相关，但剧烈体力活动则不然。在降低MCI发病风险方面，还观察到中年和老年时期的体力活动之间存在协同相互作用。此外，不运动的APOEε4携带者发生MCI的风险高于报告有体力活动的非携带者。
体力活动可降低MCI发病风险。中年和老年时期进行运动在降低MCI风险方面具有累加协同作用。
