Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong.
Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong.
Aging Ment Health. 2020 Nov;24(11):1781-1788. doi: 10.1080/13607863.2019.1636204. Epub 2019 Jul 5.
Mentally stimulating leisure activities and cognitive interventions are associated with delayed cognitive decline, although evidence has not been unequivocal, possibly due to differential contribution of the two types of activities. This study aimed to examine the respective contributions of mentally active lifestyle and structured cognitive programs on cognitive changes in older adults. This was a 2-year prospective cohort study of 1,793 healthy older adults. We recorded mentally active lifestyle and participation in cognitive program. Cognitive function was assessed using the Montreal Cognitive Assessment. Physical frailty was also screened for the potential effect on cognition. Compared to the mentally inactive group, the mentally active group had better baseline cognitive functioning (standardized mean difference of 0.08, = -3.8; < 0.001), but both groups showed a mild cognitive decline over time (both < 0.05). The mentally active group were less physical frail, more physical independent, and less depressed. Participation in structured cognitive programs was associated with cognition improvement, in older persons who had a mentally active or inactive lifestyle (standardized mean differences of 0.22 and 0.27, respectively; both < 0.01), but these gains significantly diminished at year 2 in the latter group. Lower baseline cognitive function and higher level of physical frailty predicted greater cognitive gains from structured cognitive programs. Both a mentally active lifestyle and structured cognitive programs contributed to better cognition. Structured cognitive programs appeared to add on to the benefits of a mentally active lifestyle, and predicted cognitive changes regardless of lifestyle.
脑力刺激的休闲活动和认知干预与认知能力下降的延迟有关，但证据并不明确，这可能是由于两种活动的贡献不同。本研究旨在探讨积极的脑力活动方式和结构化认知计划对老年人认知变化的各自贡献。这是一项针对 1793 名健康老年人的为期 2 年的前瞻性队列研究。我们记录了积极的脑力活动方式和参与认知计划的情况。使用蒙特利尔认知评估来评估认知功能。还筛查了身体虚弱对认知的潜在影响。与不活跃的脑力组相比，活跃的脑力组有更好的基线认知功能（标准化均数差为 0.08， = -3.8；<0.001），但两组的认知都随时间轻度下降（均<0.05）。活跃的脑力组身体更健康，身体独立性更强，抑郁程度更低。参与结构化认知计划与认知改善相关，无论是在脑力活动方式活跃还是不活跃的老年人中（标准化均数差分别为 0.22 和 0.27，均<0.01），但在后者组，这些获益在第 2 年显著降低。较低的基线认知功能和较高的身体虚弱程度预示着从结构化认知计划中获得更大的认知收益。积极的脑力活动方式和结构化认知计划都有助于改善认知。结构化认知计划似乎增加了积极的脑力活动方式的益处，并且无论生活方式如何，都可以预测认知变化。
