Department of Epidemiology, Human Genetics and Environmental Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California, USA.
J Am Geriatr Soc. 2022 Oct;70(10):2925-2937. doi: 10.1111/jgs.17926. Epub 2022 Jun 16.
Growing evidence suggests that impairment in rest-activity rhythms may be a risk factor for cognitive decline and impairment in the aging population. However, previous studies included only a limited set of rest-activity metrics and produced mixed findings. We studied a comprehensive set of parametric and nonparametric characteristics of rest-activity rhythms in relation to mild cognitive impairment (MCI) and probable dementia in a cohort of older women.
The prospective analysis included 763 women enrolled in two ancillary studies of the Women's Health Initiative (WHI): the WHI Memory Study-Epidemiology of Cognitive Health Outcomes and Objective Physical Activity and Cardiovascular Health studies. The association between accelerometry-based rest-activity parameters and centrally adjudicated MCI and probable dementia were determined using Cox regression models adjusted for sociodemographic characteristics, lifestyle factors, and comorbidities.
Overall, the results support a prospective association between weakened rest-activity rhythms (e.g., reduced amplitude and overall rhythmicity) and adverse cognitive outcomes. Specifically, reduced overall rhythmicity (pseudo F statistic), lower amplitude and activity level (amplitude/relative amplitude, mesor, and activity level during active periods of the day [M10]), and later activity timing (acrophase and midpoint of M10) were associated with a higher risk for MCI and probable dementia. Women with lower amplitude and mesor also exhibited faster cognitive decline over follow-up.
Weakened rest-activity rhythms may be predictive markers for cognitive decline, MCI, and dementia among older women.
越来越多的证据表明，静息-活动节律受损可能是衰老人群认知能力下降和受损的一个风险因素。然而，之前的研究只包括了有限的静息-活动度量集，得出的结果也不一致。我们研究了一组全面的静息-活动节律的参数和非参数特征，与老年女性中的轻度认知障碍（MCI）和可能的痴呆有关。
前瞻性分析包括参加妇女健康倡议（WHI）两项辅助研究的 763 名女性：WHI 记忆研究-认知健康结果的流行病学和客观体力活动与心血管健康研究。使用 Cox 回归模型，根据社会人口统计学特征、生活方式因素和合并症，调整了基于加速度计的静息-活动参数与经中心裁决的 MCI 和可能的痴呆之间的关联。
总的来说，结果支持静息-活动节律减弱（例如，幅度和整体规律性降低）与不良认知结果之间存在前瞻性关联。具体而言，整体规律性降低（伪 F 统计量）、幅度和活动水平降低（幅度/相对幅度、中值和白天活动期的活动水平[M10]）以及活动时间延迟（峰值和 M10 的中点）与 MCI 和可能的痴呆风险增加相关。幅度和中值较低的女性在随访期间也表现出更快的认知衰退。
静息-活动节律减弱可能是老年女性认知能力下降、MCI 和痴呆的预测指标。
