Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
Curr Alzheimer Res. 2021;18(8):638-645. doi: 10.2174/1567205018666211118100451.
The independent effect of physical work on the risk of cognitive impairment in older Chinese older adults living in rural areas remains to be elucidated.
We aimed to determine whether physical work and physical exercise can reduce the risk of cognitive impairment.
We collected data from 7,000 permanent residents without cognitive impairment (age ≥60 years) over a follow-up period of 2 years. We used the Chinese version of the Mini-Mental State Examination (MMSE) to assess cognitive function. We performed multivariate Cox regression analyses to calculate adjusted Hazard Ratios (HRs) and 95% Confidence Intervals (%95 CIs) as measures of the association between physical work/exercise and cognitive impairment while controlling for potential confounders.
Over a median follow-up period of 1.93 years, 1,224 (17.5%) of 7,000 participants developed cognitive impairment, with a total incidence of 97.69 per 1,000 person-years. After adjustment for potential confounders, participating in physical work (HR: 0.51; 95% CI: 0.43-0.60) or physical exercise (HR: 0.53; 95% CI: 0.44-0.65) was associated with a reduced risk of cognitive impairment. Stratified analyses suggested additive and multiplicative interactions between physical work and exercise. Agricultural work (HR: 0.46; 95% CI: 0.38-0.55), walking/tai chi (HR: 0.54; 95% CI: 0.44-0.67), and brisk walking/yangko (HR: 0.57; 95% CI: 0.33-0.97) exerted significant protective effects against cognitive impairment.
Both physical work and exercise can reduce the risk of cognitive impairment in older adults. Reasonable types and appropriate intensities of physical activity are recommended to prevent or delay the progression of cognitive impairment.
身体活动对农村地区老年中国老年人认知障碍风险的独立影响仍需阐明。
我们旨在确定体力工作和体育锻炼是否可以降低认知障碍的风险。
我们收集了 7000 名无认知障碍（年龄≥60 岁）的常住居民在 2 年随访期间的数据。我们使用中文版简易精神状态检查（MMSE）评估认知功能。我们进行了多变量 Cox 回归分析，以计算调整后的危险比（HR）和 95%置信区间（%95 CI）作为身体活动/锻炼与认知障碍之间关联的度量，同时控制了潜在的混杂因素。
在中位随访期为 1.93 年期间，7000 名参与者中有 1224 名（17.5%）发生了认知障碍，总发生率为每 1000 人年 97.69 例。在调整了潜在混杂因素后，参与体力工作（HR：0.51；95%CI：0.43-0.60）或体育锻炼（HR：0.53；95%CI：0.44-0.65）与认知障碍风险降低相关。分层分析表明体力工作和锻炼之间存在累加和相乘交互作用。农业工作（HR：0.46；95%CI：0.38-0.55）、散步/太极拳（HR：0.54；95%CI：0.44-0.67）和快步走/秧歌（HR：0.57；95%CI：0.33-0.97）对认知障碍有显著的保护作用。
体力工作和运动均可降低老年人认知障碍的风险。建议进行合理类型和适当强度的身体活动，以预防或延缓认知障碍的进展。
