体力活动与细颗粒物暴露对老年香港居民新发痴呆的联合关联。
The joint association of physical activity and fine particulate matter exposure with incident dementia in elderly Hong Kong residents.
机构信息
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, The University of Hong Kong, Hong Kong, China.
Psychiatric Laboratory and Mental Health Center, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
出版信息
Environ Int. 2021 Nov;156:106645. doi: 10.1016/j.envint.2021.106645. Epub 2021 May 18.
OBJECTIVE
The evidence for the beneficial effects of physical activity (PA) and potentially detrimental effects of long-term exposure to fine particulate matter (PM) on neurodegeneration diseases is accumulating. However, their joint effects remain unclear. We evaluated joint associations of habitual PA and PM exposure with incident dementia in a longitudinal elderly cohort in Hong Kong.
METHODS
A total of 57,775 elderly participants (≥65 years) without dementia were enrolled during 1998-2001 and followed up till 2011. Their information on PA and other relevant covariates were collected at baseline (1998-2001) by a standard self-administered questionnaire, including PA volumes (high, moderate, low, and inactive) and types (aerobic exercise, traditional Chinese exercise, stretching exercise, walking slowly, and no exercise). Their annual mean PM exposures at the residential address were estimated using a satellite-based spatiotemporal model. We then adopted the Cox proportional hazards model to examine the joint associations with the incidence of all-cause dementia, Alzheimer's diseases, and vascular dementia on additive and multiplicative scales.
RESULTS
During the follow-up period, we identified 1,157 incident cases of dementia, including 642 cases of Alzheimer's disease and 324 cases of vascular dementia. A higher PA level was associated with a lower risk of incident all-cause dementia (hazard ratio (HR) for the high-PA volume was 0.59 (95% CI, 0.47, 0.75), as compared with the inactive-PA), whereas a high level of PM was related to the higher risk with an HR of 1.15 (95%CI: 1.00, 1.33) compared with the low-level of PM. No clear evidence was observed of interaction between habitual PA (volume and type) and PM inhalation to incident dementia on either additive or multiplicative scale.
CONCLUSION
Habitual PA and long-term PM exposure were oppositely related to incident dementia in the Hong Kong aged population. The benefits of PA remain in people irrespective of exposure to air pollution.
目的
体力活动（PA）有益影响和长期暴露于细颗粒物（PM）对神经退行性疾病潜在有害影响的证据正在积累。然而，它们的联合效应尚不清楚。我们在香港的一个老年纵向队列中评估了习惯性 PA 和 PM 暴露与痴呆发病的联合关联。
方法
共有 57775 名无痴呆的老年参与者（≥65 岁）于 1998-2001 年期间入组，并随访至 2011 年。他们的 PA 和其他相关协变量信息在基线（1998-2001 年）时通过标准的自我管理问卷收集，包括 PA 量（高、中、低和不活动）和类型（有氧运动、传统中国运动、伸展运动、缓慢步行和不运动）。他们的居住地每年平均 PM 暴露量使用基于卫星的时空模型进行估算。然后，我们采用 Cox 比例风险模型，在加性和乘法尺度上，检验与全因痴呆、阿尔茨海默病和血管性痴呆发病率的联合关联。
结果
在随访期间，我们发现了 1157 例痴呆病例，其中包括 642 例阿尔茨海默病和 324 例血管性痴呆。较高的 PA 水平与较低的全因痴呆发病风险相关（高 PA 量的 HR 为 0.59（95%CI，0.47，0.75），与不活动的 PA 相比），而较高的 PM 水平与更高的风险相关，HR 为 1.15（95%CI：1.00，1.33），与低水平的 PM 相比。在加性或乘法尺度上，没有明显证据表明习惯性 PA（量和类型）与 PM 吸入之间存在相互作用，与痴呆发病有关。
结论
习惯性 PA 和长期 PM 暴露与香港老年人群的痴呆发病呈负相关。PA 的益处仍然存在于人们中，无论其是否暴露于空气污染。
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