中国老年人的休闲活动、教育与认知障碍：一项基于人群的纵向研究。
Leisure activities, education, and cognitive impairment in Chinese older adults: a population-based longitudinal study.
作者信息
Zhu Xinyi, Qiu Chengxuan, Zeng Yi, Li Juan
机构信息
Center on Aging Psychology,CAS Key Laboratory of Mental Health,Institute of Psychology,Chinese Academy of Sciences,Beijing,China.
Aging Research Center,Department of Neurobiology,Care Sciences and Society,Karolinska Institutet,Stockholm,Sweden.
出版信息
Int Psychogeriatr. 2017 May;29(5):727-739. doi: 10.1017/S1041610216001769. Epub 2017 Jan 9.
BACKGROUND
We examine the association between leisure-time activities and the risk of developing cognitive impairment among Chinese older people, and further investigate whether the association varies by educational level.
METHODS
This follow-up study included 6,586 participants (aged 79.5 ± 9.8 years, range 65-105 years, 51.7% female) of the Chinese Longitudinal Healthy Longevity Survey who were aged ≥65 years and were free of cognitive impairment in 2002. Incident cognitive impairment was defined at the 2005 or 2008/2009 survey following an education-based cut-off on the adapted Chinese version of Mini-Mental State Examination (MMSE). Participation in cognitive activities (e.g. reading) and non-exercise physical activity (e.g. housework) was assessed by a self-reported scale. Cox proportional hazard models were employed to examine the association of leisure activities with incident cognitive impairment while controlling for age, gender, education, occupation, residence, physical exercise, smoking, drinking, cardiovascular diseases and risk factors, negative well-being, and physical functioning, and baseline MMSE score.
RESULTS
During a five-year follow-up, 1,448 participants developed incident cognitive impairment. Overall, a high level of participation in leisure activities was associated with a 41% decreased risk of cognitive impairment compared to low-level engagement in leisure activities after controlling for age, gender, education, and other confounders. Moreover, there was a significant interaction between leisure activity and educational level, such that the beneficial effect of leisure activities on cognitive function was larger in educated elderly than their uneducated counterparts, and only educated elderly benefited from cognitive activities.
CONCLUSIONS
Late-life leisure activities protect against cognitive impairment among elderly Chinese people, and the protective effects are more profound for educated elderly.
背景
我们研究了中国老年人休闲活动与发生认知障碍风险之间的关联，并进一步探讨这种关联是否因教育水平而异。
方法
这项随访研究纳入了中国老年健康长寿纵向调查的6586名参与者（年龄79.5±9.8岁，范围65 - 105岁，女性占51.7%），他们在2002年年龄≥65岁且无认知障碍。在2005年或2008/2009年调查时，根据基于教育程度的简易精神状态检查表（MMSE）中文版的临界值定义新发认知障碍。通过自我报告量表评估参与认知活动（如阅读）和非运动性身体活动（如家务）的情况。采用Cox比例风险模型，在控制年龄、性别、教育程度、职业、居住情况、体育锻炼、吸烟、饮酒、心血管疾病及危险因素、负性幸福感、身体功能以及基线MMSE评分的同时，研究休闲活动与新发认知障碍之间的关联。
结果
在为期五年的随访期间，1448名参与者发生了新发认知障碍。总体而言，在控制年龄、性别、教育程度和其他混杂因素后，与低水平参与休闲活动相比，高水平参与休闲活动与认知障碍风险降低41%相关。此外，休闲活动与教育水平之间存在显著交互作用，即休闲活动对认知功能的有益影响在受过教育的老年人中比未受过教育的老年人更大，且只有受过教育的老年人从认知活动中受益。
结论
晚年休闲活动可预防中国老年人认知障碍，且对受过教育的老年人保护作用更为显著。
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