Fausto Bernadette A, Gluck Mark A
Aging & Brain Health Alliance, Center for Molecular & Behavioral Neuroscience, Rutgers University, Newark, NJ, USA.
Ethn Health. 2022 May;27(4):909-928. doi: 10.1080/13557858.2020.1821176. Epub 2020 Sep 15.
Because African Americans are at elevated risk for cognitive decline and Alzheimer's disease, it is important to understand which health and lifestyle factors are most important for reducing this risk. Obesity and poor sleep quality are common in lower-income, urban African Americans and have been linked to cognitive decline in older age. Fortunately, increasing aerobic fitness via regular exercise can improve cognitive function. This study sought to (1) examine the cross-sectional relationship between aerobic fitness and cognitive function in older African Americans, and (2) determine whether body mass index and sleep quality moderated the relationship between aerobic fitness and cognition. 402 older African Americans, ages 60-90 (84% female, mean education level = 14 years) completed neuropsychological testing, computerized behavioral tasks, physical performance measures, and health and lifestyle questionnaires. Hierarchical linear regressions were performed to determine associations between aerobic fitness and cognition and whether body mass index and sleep quality moderate the fitness-cognition relationship while controlling for age, sex, education, depressive symptoms, and literacy. Higher aerobic fitness levels were significantly associated with better executive function. The relationships between fitness and hippocampal-dependent cognitive functions (learning and memory, generalization) were attenuated in those who are obese (body mass index 30 kg/m) or rated their sleep quality as poor, s < .05. Our results suggest that while exercise and associated improvements in aerobic fitness are key for improved cognition, these benefits are maximized in those who maintain low body weight and get sufficient, high quality sleep. Exercise programs for older African Americans will be most effective if they are integrated with education programs that emphasize healthy eating, weight control, and sleep hygiene and conceptualize individuals as part of their broader social and environmental context.
由于非裔美国人认知能力下降和患阿尔茨海默病的风险较高，因此了解哪些健康和生活方式因素对于降低这种风险最为重要至关重要。肥胖和睡眠质量差在低收入城市非裔美国人中很常见，并且与老年人的认知能力下降有关。幸运的是，通过定期锻炼提高有氧适能可以改善认知功能。本研究旨在：（1）研究老年非裔美国人有氧适能与认知功能之间的横断面关系；（2）确定体重指数和睡眠质量是否调节了有氧适能与认知之间的关系。402名年龄在60 - 90岁的老年非裔美国人（84%为女性，平均教育水平 = 14年）完成了神经心理学测试、计算机化行为任务、身体机能测量以及健康和生活方式问卷调查。进行分层线性回归以确定有氧适能与认知之间的关联，以及体重指数和睡眠质量是否在控制年龄、性别、教育程度、抑郁症状和读写能力的同时调节了适能与认知的关系。较高的有氧适能水平与更好的执行功能显著相关。在肥胖者（体重指数≥30 kg/m²）或睡眠质量被评为差的人群中，适能与海马体依赖的认知功能（学习和记忆、泛化）之间的关系减弱，P < 0.05。我们的研究结果表明，虽然锻炼及相关的有氧适能改善是认知改善的关键，但这些益处在保持低体重且获得充足高质量睡眠的人群中最大化。如果老年非裔美国人的锻炼计划与强调健康饮食、体重控制和睡眠卫生的教育计划相结合，并将个体视为其更广泛社会和环境背景的一部分，那么这些计划将最为有效。
