Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK.
British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK.
BMC Med. 2021 Dec 2;19(1):305. doi: 10.1186/s12916-021-02172-5.
Previous cohort studies have investigated the relationship between self-reported physical activity (PA) and dementia. Evidence from objective device-measured PA data is lacking. This study aimed to explore the association of device-measured PA with the risk of dementia incidence and common subtypes (Alzheimer's disease [AD] and vascular dementia) using the UK Biobank study.
84,854 participants (55.8% women), invited to participate in the device-measured PA between 2013 and 2015, were included in this prospective cohort study. Wrist accelerometers were used to measure light, moderate, vigorous, moderate-to-vigorous PA (MVPA) and total PA intensity and duration (MET/min/week). Incident dementia (fatal and non-fatal) was extracted from hospital episodes records for incidence and death register for mortality. Incidence follow-up was carried out until the end of March 2021in England and Scotland and the end of March 2018 in Wales. Mortality data were available until February 2021. Nonlinear associations were first investigated using penalised cubic splines fitted in the Cox proportional hazard models. In addition, using MVPA, five categories were created. Associations of these categories with the outcomes were investigated using Cox proportional hazard models. Analyses were adjusted for sociodemographic, lifestyle and health-related factors.
After a median follow-up of 6.3 years, 678 individuals were diagnosed with dementia. Evidence of nonlinearity was observed for all PA modes and all-cause dementia. For categories of MVPA, there was a significant trend towards a low risk of overall dementia when higher levels of MVPA were achieved (HR 0.66 [95% CI 0.62 to 0.70]. The lowest risk was identified in individuals who performed more than 1200 MET/min/week, those who had 84% (95% CI 0.12 to 0.21) lower risk of incident dementia compared to those who performed < 300 MET/min/week.
Participants with higher PA levels had a lower risk of incident dementia than those less active, independently of sociodemographic, lifestyle factors and comorbidity. Considering that the majority of previous studies have reported this association using self-reported data, our findings highlight the strong inverse association between PA objectively measured and incident dementia.
先前的队列研究已经调查了自我报告的身体活动（PA）与痴呆之间的关系。缺乏来自客观设备测量 PA 数据的证据。本研究旨在使用英国生物银行研究，探索设备测量的 PA 与痴呆发病率和常见亚型（阿尔茨海默病 [AD] 和血管性痴呆）风险之间的关联。
共纳入 84854 名参与者（55.8%为女性），邀请他们参加 2013 年至 2015 年期间的设备测量 PA。腕部加速度计用于测量轻、中、剧烈、中高强度 PA（MVPA）和总 PA 强度和时间（MET/min/周）。从医院病例记录中提取痴呆（致命和非致命）的发病情况，从死亡登记处提取死亡率。在英格兰和苏格兰，发病随访截至 2021 年 3 月底，在威尔士，截至 2018 年 3 月底。死亡率数据截至 2021 年 2 月。首先使用 Cox 比例风险模型中拟合的惩罚三次样条曲线来研究非线性关联。此外，使用 MVPA，创建了五个类别。使用 Cox 比例风险模型研究这些类别与结果的关联。分析调整了社会人口统计学、生活方式和健康相关因素。
中位随访 6.3 年后，有 678 人被诊断为痴呆。所有 PA 模式和全因痴呆均存在非线性关系的证据。对于 MVPA 类别，当达到较高水平的 MVPA 时，整体痴呆的风险呈显著降低趋势（HR 0.66 [95%CI 0.62 至 0.70]）。风险最低的是那些每周进行超过 1200 MET/min/周的人，与每周进行<300 MET/min/周的人相比，他们发生痴呆的风险降低了 84%（95%CI 0.12 至 0.21）。
与活动较少的参与者相比，PA 水平较高的参与者发生痴呆的风险较低，这与社会人口统计学、生活方式因素和合并症无关。鉴于大多数先前的研究都是使用自我报告的数据报告这种关联，我们的研究结果强调了客观测量的 PA 与痴呆发病率之间的强烈反比关系。
