Liu Xin, Ruan Ye, Huang Limei, Guo Yanfei, Sun Shuangyuan, Chen Hao, Gao Junling, Shi Yan, Xiao Qianyi
School of Public Health, Fudan University, Shanghai, 200032, China.
Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China.
BMC Geriatr. 2021 Apr 9;21(1):236. doi: 10.1186/s12877-021-02180-3.
Cognitive leisure activity, such as reading, playing mahjong or cards and computer use, is common among older adults in China. Previous studies suggest a negative correlation between cognitive leisure activity and cognitive impairment. However, the relationship between cognitive leisure activity and all-cause mortality has rarely been reported.
This study aims to explore the relationships between cognitive leisure activity and all-cause mortality in a community-based older people cohort in China.
The current study sample comprised 4003 community residents aged ≥60 y who were enrolled in June 2015, and were followed up every year from 2015 to 2018. Reading, playing mahjong or cards and computer use were measured by questionnaires and summed into a cognitive leisure activity index (CLAI) score. Time-Dependent Cox Regression Model and Kaplan-Meier survival analysis were used to examine the association of cognitive leisure activity with all-cause mortality.
During the 4-year follow-up of 4003 participants, 208 (5.2%) deaths were registered. Of all participants, 66.8, 26.7, 6.1 and 0.35% reported CLAI scores of 0, 1, 2 and 3, respectively. A strong association was noted between the CLA score and all-cause mortality (adjusted hazard ratio [HR] = 0.72, 95% confidence intervals [CI]: 0.54-0.97, P = 0.028). Stratified analysis suggested that a higher CLAI score was significantly associated with a decreased risk of all-cause mortality mainly among those who were male, aged ≥80 y, cognitively impaired, and not diagnosed with cancer (P < 0.05).
Cognitive leisure activity was positively associated with reduced risk of death from all cause among the older people in major city of China, which helped promote a comprehensive understanding of health characteristics at advanced ages.
认知性休闲活动，如阅读、打麻将或纸牌以及使用电脑，在中国老年人中很常见。先前的研究表明认知性休闲活动与认知障碍之间存在负相关。然而，认知性休闲活动与全因死亡率之间的关系鲜有报道。
本研究旨在探讨中国一个社区老年人群队列中认知性休闲活动与全因死亡率之间的关系。
本研究样本包括2015年6月纳入的4003名年龄≥60岁的社区居民，从2015年至2018年每年进行随访。通过问卷调查测量阅读、打麻将或纸牌以及使用电脑的情况，并汇总成认知性休闲活动指数（CLAI）得分。采用时间依赖性Cox回归模型和Kaplan-Meier生存分析来检验认知性休闲活动与全因死亡率的关联。
在对4003名参与者进行的4年随访期间，记录到208例（5.2%）死亡。在所有参与者中，分别有66.8%、26.7%、6.1%和0.35%的人报告CLAI得分为0、1、2和3。CLAI得分与全因死亡率之间存在显著关联（调整后的风险比[HR]=0.72，95%置信区间[CI]：0.54-0.97，P=0.028）。分层分析表明，较高的CLAI得分与全因死亡率风险降低显著相关，主要见于男性、年龄≥80岁、认知功能受损且未被诊断患有癌症的人群（P<0.05）。
在中国大城市的老年人中，认知性休闲活动与全因死亡风险降低呈正相关，这有助于促进对高龄健康特征的全面理解。
