Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
Department of Public Health, Kochi University Medical School, Kochi, Japan.
JAMA Netw Open. 2022 Mar 1;5(3):e224590. doi: 10.1001/jamanetworkopen.2022.4590.
The associations of daily total physical activity and total moderate to vigorous physical activity (MVPA) with dementia are still unclear.
To investigate the association between daily total physical activity and subsequent risk of disabling dementia in large-scale, extended follow-up prospective study.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study used data from questionnaires collected between 2000 and 2003 from 8 areas from the Japan Public Health Center-based Prospective Disabling Dementia Study. Participants included adults aged 50 to 79 years in with available follow-up data on disabling dementia. Data analysis was performed from February 1, 2019, to July 31, 2021.
Daily total physical activity, total MVPA, and leisure-time MVPA.
The main outcome was incidence of disabling dementia during the dementia ascertainment period between 2006 and 2016, based on the national long-term care insurance system. Risks of dementia in association with daily total physical activity, total MVPA, and leisure time MVPA were calculated using multivariable adjusted hazard ratios (aHRs).
Among 43 896 participants (mean [SD] age, 61.0 [7.5] years; 23 659 [53.9%] women), 5010 participants were newly diagnosed with disabling dementia during a mean (SD) of 9.5 (2.8) years in the dementia ascertainment period. In the highest daily total physical activity group, compared with the lowest activity group, risk of dementia was lower in men (aHR, 0.75 [95% CI, 0.66-0.85]; P for trend < .001) and women (aHR, 0.75 [95% CI, 0.67-0.84]; P for trend < .001). Similar inverse associations were observed in men and women for total MVPA (men: aHR, 0.74 [95% CI, 0.65-0.84]; P for trend < .001; women: aHR, 0.74 [95% CI, 0.66-0.83]; P for trend < .001) and leisure-time MVPA (men: aHR, 0.59 [95% CI, 0.53-0.67]; P for trend < .001; women: aHR, 0.70 [95% CI, 0.63-0.78]; P for trend < .001). However, these inverse associations disappeared when participants diagnosed with disabling dementia within 7 years of the starting point were excluded in men (aHR, 0.93 [95%CI, 0.77-1.12]) and within 8 years were excluded in women (aHR, 0.86 [95%CI, 0.71-1.04]). The association remained significant among men in the highest vs lowest group of leisure-time MVPA, after excluding participants diagnosed within the first 9 years (aHR, 0.72 [95% CI, 0.56-0.92]; P for trend = .004).
This cohort study examined associations of daily total physical activity and total MVPA with risk of disabling dementia. The findings suggest that a high level of leisure-time MVPA was associated with decreased risk of disabling dementia in men.
每日总体力活动和总中度至剧烈体力活动（MVPA）与痴呆的关联仍不清楚。
在大规模、长期随访前瞻性研究中，调查每日总体力活动与随后发生失能性痴呆风险的关联。
设计、地点和参与者：这项前瞻性队列研究使用了 2000 年至 2003 年期间从日本公共卫生中心前瞻性失能性痴呆研究的 8 个地区收集的问卷数据。参与者包括年龄在 50 岁至 79 岁之间、有失能性痴呆随访数据的成年人。数据分析于 2019 年 2 月 1 日至 2021 年 7 月 31 日进行。
每日总体力活动、总 MVPA 和休闲时间 MVPA。
主要结局是根据国家长期护理保险制度，在 2006 年至 2016 年的痴呆确定期间发生失能性痴呆的发生率。使用多变量调整后的风险比（aHR）计算与每日总体力活动、总 MVPA 和休闲时间 MVPA 相关的痴呆风险。
在 43896 名参与者（平均[标准差]年龄 61.0[7.5]岁；23659[53.9%]名女性）中，在痴呆确定期间，有 5010 名参与者被新诊断为失能性痴呆，平均（标准差）为 9.5（2.8）年。在最高每日总体力活动组中，与最低活动组相比，男性（aHR，0.75[95%CI，0.66-0.85]；趋势 P<.001）和女性（aHR，0.75[95%CI，0.67-0.84]；趋势 P<.001）患痴呆的风险较低。在男性和女性中，总 MVPA 也观察到类似的反向关联（男性：aHR，0.74[95%CI，0.65-0.84]；趋势 P<.001；女性：aHR，0.74[95%CI，0.66-0.83]；趋势 P<.001）和休闲时间 MVPA（男性：aHR，0.59[95%CI，0.53-0.67]；趋势 P<.001；女性：aHR，0.70[95%CI，0.63-0.78]；趋势 P<.001）。然而，当排除男性中发病后 7 年内（aHR，0.93[95%CI，0.77-1.12]）和女性中发病后 8 年内（aHR，0.86[95%CI，0.71-1.04]）的参与者后，这些反向关联在男性中消失。在排除发病后前 9 年的参与者后（aHR，0.72[95%CI，0.56-0.92]；趋势 P=.004），男性在最高与最低休闲时间 MVPA 组之间的关联仍然显著。
这项队列研究检查了每日总体力活动和总 MVPA 与失能性痴呆风险的关联。研究结果表明，高水平的休闲时间 MVPA 与男性失能性痴呆风险降低有关。
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