From the Rush Alzheimer's Disease Center (A.S.B., L.Y., R.S.W., R.J.D., C.G., S.E.L., J.A.S., D.A.B.), and Departments of Neurological Sciences (A.S.B., L.Y., R.S.W., C.G., S.E.L., J.A.S., D.A.B.), Radiology (R.J.D.), Psychology (R.S.W.), and Pathology (Neuropathology) (J.A.S.), Rush University Medical Center, Chicago, IL; and Department of Neurology (A.L.), University of Toronto, Canada.
Neurology. 2019 Feb 19;92(8):e811-e822. doi: 10.1212/WNL.0000000000006954. Epub 2019 Jan 16.
To examine the associations of physical activity, Alzheimer disease (AD), and other brain pathologies and cognition in older adults.
We studied 454 brain autopsies from decedents in a clinical-pathologic cohort study. Nineteen cognitive tests were summarized in a global cognitive score. Total daily physical activity summarized continuous multiday recordings of activity during everyday living in the community setting. A global motor ability score summarized 10 supervised motor performance tests. A series of regression analyses were used to examine associations of physical activity, AD, and other brain pathologies with global cognition proximate to death controlling for age, sex, education, and motor abilities.
Higher levels of total daily activity (estimate 0.148, 95% confidence interval 0.053-0.244, SE 0.049, = 0.003) and better motor abilities (estimate 0.283, 95% confidence interval, 0.175-0.390, SE 0.055, < 0.001) were independently associated with better cognition. These independent associations remained significant when terms for AD and other pathologies were added as well as in sensitivity analyses excluding cases with poor cognition or dementia. Adding interaction terms, the associations of total daily activity and motor abilities with cognition did not vary in individuals with and without dementia. The associations of AD and other pathologies with cognition did not vary with the levels of total daily activity or motor abilities.
Physical activity in older adults may provide cognitive reserve to maintain function independent of the accumulation of diverse brain pathologies. Further studies are needed to identify the molecular mechanisms underlying this potential reserve and to ensure the causal effects of physical activity.
探讨体力活动、阿尔茨海默病（AD）和其他脑部病变与老年人认知之间的关联。
我们研究了临床病理队列研究中 454 例尸检大脑。19 项认知测试汇总为一个总体认知评分。总日常体力活动通过日常社区生活中连续多天的活动记录进行总结。一个总体运动能力评分汇总了 10 项监督运动表现测试。我们使用一系列回归分析来检验体力活动、AD 和其他脑部病变与接近死亡时的总体认知之间的关联，控制年龄、性别、教育程度和运动能力。
更高水平的总日常活动（估计值为 0.148，95%置信区间为 0.053-0.244，SE 为 0.049， = 0.003）和更好的运动能力（估计值为 0.283，95%置信区间为 0.175-0.390，SE 为 0.055， < 0.001）与更好的认知能力独立相关。当将 AD 和其他病变的术语添加为以及在排除认知能力差或痴呆病例的敏感性分析中，这些独立关联仍然显著。添加交互项时，体力活动和运动能力与认知的关联在痴呆和非痴呆个体中没有差异。AD 和其他病变与认知的关联不受总日常活动或运动能力水平的影响。
老年人的体力活动可能提供认知储备，以独立于多种脑部病变的积累来维持功能。需要进一步研究以确定这种潜在储备的分子机制，并确保体力活动的因果效应。
