Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Therese Pei Fong Chow Research Centre for Prevention of Dementia, The Chinese University of Hong Kong, Hong Kong, China.
Int J Geriatr Psychiatry. 2019 Dec;34(12):1792-1798. doi: 10.1002/gps.5194. Epub 2019 Aug 27.
The objective of this study is to examine the effects of recent regular participation leisure activities upon cognitive functions between 3 and 6 months after stroke or transient ischemic attack (TIA). We also explored whether the cognitive effects interacted with the severity of white matter hyperintensities (WMH), a marker of cerebral white matter disease, in patients with low or high education.
Two-hundred and ninety-two subjects with mean age of 66.1 (11.0) years were recruited at median 161(131-180) days post index event. WMH volume was evaluated using a semi-automated method on MRI brain. Cognitive functions were measured using the Montreal Cognitive Assessment (MoCA). Multivariable linear regression analysis was conducted to explore the associations between leisure activity participation with WMH and the moderating effects of leisure activities upon relationship between WMH and MoCA. Analyses were further stratified by low (<6 years) or high education (≥6 years). All models were adjusted with age, sex, and years of education.
Physical activity (PA), but not intellectual activity (IA), was negatively related to WMH volume (P < .05). IA exerted a main effect on MoCA performance (b = 3.21, P < .001). PA, but not IA, significantly interacted with WMH volume (b = -0.18, P < .01) on MoCA performance, but the interaction was only significant in the lower education group (b = 0.28, P < .01) but not in the higher education group.
In patients with stroke/TIA, IA confers general cognitive benefits. Regular participation in PA negatively correlated with WMH volume. In patients with low education, PA increases resilience against vascular cognitive impairment.
本研究旨在探讨 3 至 6 个月后脑卒中或短暂性脑缺血发作（TIA）患者近期有规律地参与休闲活动对认知功能的影响。我们还探讨了认知效应是否与脑白质病变的标志物——脑白质高信号（WMH）的严重程度相互作用，以及在低或高教育水平的患者中是否相互作用。
共招募了 292 名平均年龄为 66.1（11.0）岁的患者，在指数事件后中位数 161（131-180）天进行评估。WMH 体积采用 MRI 脑半自动化方法进行评估。采用蒙特利尔认知评估（MoCA）测量认知功能。采用多变量线性回归分析探讨休闲活动与 WMH 的关系，以及休闲活动对 WMH 与 MoCA 之间关系的调节作用。分析进一步分为低（<6 年）或高（≥6 年）教育水平组。所有模型均调整了年龄、性别和受教育年限。
体力活动（PA），但不是智力活动（IA），与 WMH 体积呈负相关（P <.05）。IA 对 MoCA 表现有主要影响（b = 3.21，P <.001）。PA，但不是 IA，与 MoCA 表现的 WMH 体积显著相互作用（b = -0.18，P <.01），但这种相互作用仅在低教育组中显著（b = 0.28，P <.01），而在高教育组中不显著。
在脑卒中/TIA 患者中，IA 具有普遍的认知益处。PA 有规律的参与与 WMH 体积呈负相关。在教育程度较低的患者中，PA 增加了对血管性认知障碍的抵抗力。
