a Masley Optimal Health Center , St. Petersburg , Florida.
b University of South Florida , St. Petersburg , Florida.
J Am Coll Nutr. 2017 Nov-Dec;36(8):617-623. doi: 10.1080/07315724.2017.1336128. Epub 2017 Sep 14.
Rates of mild cognitive impairment and Alzheimer's disease are increasing rapidly. None of the current treatment regimens for Alzheimer's disease are effective in arresting progression. Lifestyle choices may prevent cognitive decline. This study aims to clarify which factors best predict cognitive function.
This was a prospective cross-sectional analysis of 799 men and women undergoing health and cognitive testing every 1 to 3 years at an outpatient center. This study utilizes data collected from the first patient visit. Participant ages were 18 to 88 (mean = 50.7) years and the sample was 26.6% female and 73.4% male.
Measurements were made of body composition, fasting laboratory and anthropometric measures, strength and aerobic fitness, nutrient and dietary intake, and carotid intimal media thickness (IMT). Each participant was tested with a computerized neurocognitive test battery. Cognitive outcomes were assessed in bivariate analyses using t-tests and correlation coefficients and in multivariable analysis (controlling for age) using multiple linear regression.
The initial bivariate analyses showed better Neurocognitive Index (NCI) scores with lower age, greater fitness scores (push-up strength, VOmax, and exercise duration during treadmill testing), and lower fasting glucose levels. Better cognitive flexibility scores were also noted with younger age, lower systolic blood pressure, lower body fat, lower carotid IMT scores, greater fitness, and higher alcohol intake. After controlling for age, factors that remained associated with better NCI scores include no tobacco use, lower fasting glucose levels, and better fitness (aerobic and strength). Higher cognitive flexibility scores remained associated with greater aerobic and strength fitness, lower body fat, and higher intake of alcohol.
Modifiable biomarkers that impact cognitive performance favorably include greater aerobic fitness and strength, lower blood sugar levels, greater alcohol intake, lower body fat, and avoidance of tobacco. Further studies are warranted to study whether modifying these lifestyle factors improves cognitive function and slows cognitive decline.
轻度认知障碍和阿尔茨海默病的发病率正在迅速上升。目前尚无治疗阿尔茨海默病的方法能有效阻止其进展。生活方式的选择可能有助于预防认知能力下降。本研究旨在明确哪些因素能最好地预测认知功能。
这是一项对 799 名在门诊中心进行健康和认知测试的男性和女性进行的前瞻性横断面分析。本研究利用了每位患者首次就诊时的数据。参与者年龄在 18 岁至 88 岁之间（平均年龄为 50.7 岁），样本中女性占 26.6%，男性占 73.4%。
通过计算机神经认知测试对每位参与者进行了测试。在双变量分析中，使用 t 检验和相关系数评估认知结果，在多变量分析（控制年龄）中使用多元线性回归评估认知结果。初始的双变量分析表明，神经认知指数（NCI）评分较好与年龄较低、体能得分较高（俯卧撑力量、最大摄氧量和跑步机测试期间的运动时间）、空腹血糖水平较低有关。认知灵活性评分也与年龄较小、收缩压较低、体脂较低、颈动脉内膜中层厚度（IMT）评分较低、体能较好和饮酒量较高有关。在控制年龄后，与更好的 NCI 评分相关的因素包括不吸烟、空腹血糖水平较低和更好的体能（有氧和力量）。更高的认知灵活性评分仍然与更高的有氧和力量体能、更低的体脂和更高的酒精摄入量有关。
对认知表现有积极影响的可改变生物标志物包括更高的有氧体能和力量、较低的血糖水平、更多的酒精摄入、更低的体脂和避免吸烟。进一步的研究需要研究是否可以通过改变这些生活方式因素来改善认知功能并减缓认知能力下降。
