Division of Epidemiology, Department of Health Informatics and Public Health, Graduate School of Medicine, Tohoku University School of Public Health, Sendai, Japan.
Int J Geriatr Psychiatry. 2019 Jan;34(1):204-209. doi: 10.1002/gps.5011. Epub 2018 Nov 8.
This study examined the hypothesis that time spent walking daily has a marked impact on incident dementia.
METHODS/DESIGN: First, we analyzed data from a Japanese cohort (n = 13 990 aged ≥65 y) to obtain hazard ratios. Time spent walking per day (<0.5, 0.5-1, or ≥1 h) was assessed using a self-reported questionnaire. Data on 5.7-year incident dementia were retrieved from the public long-term care insurance database. After estimating the multivariate-adjusted hazard ratios (HRs) of incident dementia using the Cox model, the population attributable fraction (PAF) was calculated using the prevalence in a representative Japanese survey, the "National Health and Nutrition Survey".
The time spent walking per day showed an inverse association with incident dementia: the multiple-adjusted HRs (95% confidence intervals) were 1.00 (reference) for less than 0.5 hour, 0.81 [0.71, 0.92] for 0.5 to 1 hour, and 0.72 [0.62, 0.84] for more than or equal to 1 hour. Our estimates indicate that 18.1% of dementia cases would be attributable to walking if all subjects walked more than or equal to 1 h/d and 14.0% if subjects increased their daily time spent walking to one level above the present one (<0.5 to 0.5-1 or 0.5-1 to ≥1 h).
Our results suggest that the daily time spent walking has a considerable preventive impact on incident dementia in Japan.
本研究旨在检验以下假设，即每天行走的时间对痴呆症的发生有显著影响。
方法/设计：首先，我们分析了来自日本队列（n=13990 名年龄≥65 岁）的数据，以获得风险比。每天行走的时间（<0.5、0.5-1 或≥1 小时）使用自我报告问卷进行评估。从公共长期护理保险数据库中检索到 5.7 年的痴呆症发病数据。使用 Cox 模型估计多变量调整后的痴呆症发病风险比（HR）后，使用代表性日本调查（“国家健康和营养调查”）的患病率计算人群归因分数（PAF）。
每天行走的时间与痴呆症发病呈负相关：多变量调整后的 HR（95%置信区间）分别为<0.5 小时为 1.00（参考），0.5 至 1 小时为 0.81 [0.71, 0.92]，≥1 小时为 0.72 [0.62, 0.84]。我们的估计表明，如果所有受试者每天行走≥1 小时，那么 18.1%的痴呆症病例归因于行走，如果受试者将每天的行走时间增加到目前水平以上（<0.5 至 0.5-1 或 0.5-1 至≥1 小时），则有 14.0%的病例归因于行走。
我们的结果表明，在日本，每天行走的时间对痴呆症的发生有相当大的预防作用。
