Department of Orthopedics (J.Z.), Orthopedic Research Institute (J.Z.), National Clinical Research Center for Geriatrics (J.Z.), West China Biomedical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Division of Nephrology (W.C.), Kidney Research Institute (W.C.), State Key Laboratory of Biotherapy and Cancer Center (W.C.), and Department of Anesthesiology (L.Y.), West China Hospital, Sichuan University, Chengdu; Medical Big Data Center (F.G., Y.Z., Y.Q., H.Y., H.S.), Sichuan University, Chengdu, China; Institute of Environmental Medicine (F.F.), Karolinska Institute, Stockholm, Sweden; and Center of Public Health Sciences (H.S.), Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
Neurology. 2022 Aug 23;99(8):e799-e813. doi: 10.1212/WNL.0000000000200701. Epub 2022 Jul 27.
The association between patterns of physical/mental activity and dementia and how it is affected by disease susceptibility remains unknown. We aimed to examine the association between patterns of physical and mental activity and dementia and whether it can be modified by disease susceptibility to dementia.
In a prospective cohort study based on UK Biobank, 501,376 dementia-free participants were recruited in 2006-2010 and followed from 1 year after the recruitment date until the end of 2019 for ascertainment of dementia. Data on physical (i.e., physical activity at leisure time, housework-related activity, and transportation) and mental (i.e., intelligence, social contact, and use of electronic device) activity were collected using questionnaires at recruitment. Cox models were used to estimate the associations of physical and mental activity-related items, as well as major activity patterns identified by principal component analysis, with the risk of dementia, adjusted for multiple confounders. The modification role of disease susceptibility on such associations was assessed through stratified analyses by the polygenic risk score (PRS) of dementia generated based on summary statistics of independent genome-wide association studies, by the genotype, and by the self-reported family history of dementia.
The mean age at recruitment was 56.53, and 45.60% of the participants were male. During a mean follow-up of 10.66 years, 5,185 dementia cases were identified. When analyzed separately, multiple studied items related to physical and mental activity showed significant associations with the risk of dementia. The pattern analyses revealed that a higher level of adherence to activity patterns related to frequent vigorous and other exercises (hazard ratio 0.65, 95% CI 0.59-0.71), housework-related activity (0.79, 0.72-0.85), and friend/family visit (0.85, 0.75-0.96) was associated with a lower risk of dementia. We obtained comparable results for vascular dementia and Alzheimer disease as well as in the stratified analyses by the PRS for dementia, genotype, or family history of dementia.
Activity patterns more adherent to frequent vigorous and other exercises, housework-related activity, and friend/family visit were associated with a reduced risk of multiple types of dementia. Such associations are independent of disease susceptibility, highlighting the potential of these physical and mental activity patterns, as effective interventions, in the primary prevention of dementia.
身体/精神活动模式与痴呆的关联及其受痴呆病易感性的影响尚不清楚。我们旨在研究身体和精神活动模式与痴呆的关联，以及这种关联是否可以通过对痴呆的疾病易感性来改变。
在基于英国生物库的前瞻性队列研究中，我们于 2006 年至 2010 年招募了 501376 名无痴呆的参与者，并从招募日期后的第 1 年开始随访，直到 2019 年底，以确定痴呆的发生情况。使用问卷收集身体（即闲暇时间的体力活动、家务相关活动和交通）和精神（即智力、社会接触和电子设备使用）活动的数据。使用 Cox 模型估计与身体和精神活动相关项目的关联，以及通过主成分分析确定的主要活动模式，与痴呆风险的关联，调整了多种混杂因素。通过基于独立全基因组关联研究汇总统计数据生成的痴呆多基因风险评分 (PRS)、 基因型和自我报告的痴呆家族史对这种关联的修饰作用进行分层分析，评估疾病易感性的修饰作用。
招募时的平均年龄为 56.53 岁，45.60%的参与者为男性。在平均 10.66 年的随访期间，确定了 5185 例痴呆病例。单独分析时，多项与身体和精神活动相关的研究项目与痴呆风险显著相关。模式分析显示，更遵守与频繁剧烈运动和其他运动相关的活动模式（危险比 0.65，95%CI 0.59-0.71）、家务相关活动（0.79，0.72-0.85）和朋友/家庭访问（0.85，0.75-0.96）与痴呆风险降低相关。我们还在对痴呆的 PRS、基因型或痴呆家族史进行分层分析时，获得了血管性痴呆和阿尔茨海默病的类似结果。
更遵守频繁剧烈运动和其他运动、家务相关活动和朋友/家庭访问的活动模式与多种类型的痴呆风险降低相关。这些关联独立于疾病易感性，突出了这些身体和精神活动模式作为有效的干预措施，在痴呆的一级预防中的潜在作用。
