体力活动与认知功能在γ间隙增高的老年人群中的研究
Physical Activity and Cognitive Function among Older Adults with an Elevated Gamma Gap.
机构信息
Physical Activity Epidemiology Laboratory, Exercise Psychology Laboratory, The University of Mississipi, University, Mississippi, USA.
Jackson Heart Study Vanguard Center of Oxford, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, Mississippi,
出版信息
Med Princ Pract. 2018;27(6):531-536. doi: 10.1159/000493732. Epub 2018 Sep 14.
OBJECTIVE
An elevated gamma gap is indicative of high serum concentrations of globulin proteins, some of which elicit acute inflammatory responses. An impaired cognitive function has been linked to central and peripheral inflammation, while exercise is associated with protective, anti-inflammatory benefits. In this study, we evaluated whether the gamma gap is associated with cognitive function among older adults and whether physical activity is favorably associated with cognitive function among those with an elevated gamma gap.
MATERIALS AND METHODS
Data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) were used to identify 2,352 older adults aged between 60 and 85 years. The gamma gap was evaluated by subtracting albumin from total protein, i.e., gamma gap = total protein (g/dL) - albumin (g/dL). Those at or above 3.1 g/dL (31.0 g/L) were considered to have an elevated gamma gap. The Digit Symbol Substitution Test (DSST) was used to assess cognitive function tasks of pairing and free recall among participants. Participants were asked open-ended questions about participation in leisure-time physical activity over the previous 30 days.
RESULTS
Those with an elevated gamma gap (DSST, 44.8) had a lower cognitive function score when compared to those without an elevated gamma gap (DSST, 50.1) (p < 0.001). After adjustments, and among those with an elevated gamma gap, those meeting the moderate-to-vigorous intensity physical activity (MVPA) guidelines (vs. not meeting them) had a DSST score of 6.42 units higher (β = 6.42, 95% CI 3.85-8.99, p < 0.001).
CONCLUSION
In this national sample of older adults, the gamma gap was associated with cognitive function, and among those with an elevated gamma gap, meeting the physical activity guidelines was associated with a higher cognitive function. Relevant clinical implications are discussed, as the gamma gap may be predictive of the risk for early mortality and reduced quality of life. Experimental work is needed to investigate whether physical activity training programs are effective in reducing an elevated gamma gap and preserving optimal cognitive functioning among at-risk individuals.
目的
γ 间隙升高表明球蛋白蛋白血清浓度升高，其中一些会引起急性炎症反应。认知功能受损与中枢和外周炎症有关，而运动与保护性、抗炎作用有关。在这项研究中，我们评估了 γ 间隙是否与老年人的认知功能有关，以及在 γ 间隙升高的人群中，体力活动是否与认知功能呈正相关。
材料和方法
使用 1999-2002 年全国健康和营养调查（NHANES）的数据，确定了 2352 名年龄在 60 至 85 岁之间的老年人。γ 间隙通过从总蛋白中减去白蛋白来评估，即 γ 间隙=总蛋白（g/dL）-白蛋白（g/dL）。白蛋白水平在 3.1g/dL（31.0g/L）或以上的被认为是 γ 间隙升高。数字符号替代测试（DSST）用于评估参与者的配对和自由回忆认知功能任务。参与者被问及过去 30 天内参与休闲时间体力活动的开放式问题。
结果
与没有 γ 间隙升高的人相比（DSST 为 50.1），γ 间隙升高的人（DSST 为 44.8）认知功能得分较低（p<0.001）。经过调整，在 γ 间隙升高的人群中，符合中高强度体力活动（MVPA）指南（不符合）的人 DSST 得分高 6.42 分（β=6.42，95%CI 3.85-8.99，p<0.001）。
结论
在这项全国性的老年人样本中，γ 间隙与认知功能有关，在 γ 间隙升高的人群中，符合体力活动指南与更高的认知功能有关。讨论了相关的临床意义，因为 γ 间隙可能预示着早期死亡率和生活质量降低的风险。需要开展实验工作，以研究体力活动训练计划是否能有效降低 γ 间隙升高，并维持高危人群的最佳认知功能。
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