Wei Kai, Yang Junjie, Lin Shaohui, Mei Yi, An Na, Cao Xinyi, Jiang Lijuan, Liu Chi, Li Chunbo
Department of Traditional Chinese Medicine, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai 201108, China.
J Clin Med. 2022 Aug 30;11(17):5122. doi: 10.3390/jcm11175122.
Previous studies have confirmed that both healthy diets and physical exercise have preventive effects with respect to cognitive decline with aging. The aim of this study was to investigate whether the associations of physical exercise with cognitive impairment differ in community-dwelling older adults with different dietary habits.
In the 2008/2009 wave of the Chinese Longitudinal Healthy Longevity Survey, 14,966 community-dwelling older adults (≥65 years) were included for analyses. Dietary habits (including daily intake of fruits, vegetables, tea, meat, fish, eggs, food made from beans, salt-preserved vegetables, sugar, garlic, milk products, nut products, mushroom or algae, vitamins and medicinal plants) and physical exercise were assessed. Cognitive impairment was evaluated using the Chinese version of the MMSE in the 2008/2009 and 2011/2012 waves. The effect modifications of physical exercise on cognitive impairment by dietary habits were estimated using logistic regression models.
Older adults who practiced physical exercise exhibited a trend of decreased probability of cognitive impairment at baseline and follow-up (OR = 0.92, 95% CI = 0.80-1.06, = 0.273; OR = 0.83, 95% CI = 0.65-1.05, = 0.123, respectively) compared with those who did not practice physical exercise. When stratified by dietary habits, physical exercise had a protective effect with respect to prevalent cognitive impairment in older adults who ate fruits (OR = 0.74, 95% CI = 0.58-0.94, = 0.016), ate food made from beans (OR = 0.76, 95% CI = 0.62-0.93, = 0.007), did not eat sugar (OR = 0.81, 95% CI = 0.68-0.98, = 0.028) and ate milk products (OR = 0.75, 95% CI = 0.57-0.97, = 0.030); in the longitudinal analyses, physical exercise had a protective effect with respect to incident cognitive impairment in older adults who ate fruits (OR = 0.63, 95% CI = 0.41-0.98, = 0.040) and milk products (OR = 0.57, 95% CI = 0.35-0.94, = 0.027). Fruits, food made from beans and milk products modified the associations of physical exercise with prevalent cognitive impairment ( values for interaction = 0.008, 0.005 and 0.082, respectively).
The associations of physical exercise with cognitive impairment could be modified by certain dietary habits. Physical exercise was not found to be significantly protective with respect to cognitive impairment in older adults unless they had specific dietary habits. Thus, dietary habits should be emphasized when investigating the beneficial effects of physical exercise on cognitive function in community-dwelling older adults.
先前的研究已证实，健康饮食和体育锻炼对衰老导致的认知衰退均具有预防作用。本研究的目的是调查体育锻炼与认知障碍之间的关联在具有不同饮食习惯的社区居住老年人中是否存在差异。
在中国老年健康长寿纵向调查2008/2009年的调查周期中，纳入14966名社区居住的老年人（≥65岁）进行分析。评估了饮食习惯（包括水果、蔬菜、茶、肉类、鱼类、蛋类、豆类制品、腌菜、糖、大蒜、奶制品、坚果制品、蘑菇或藻类、维生素和药用植物的每日摄入量）和体育锻炼情况。在2008/2009年和2011/2012年的调查周期中，使用中文版简易精神状态检查表评估认知障碍。使用逻辑回归模型估计饮食习惯对体育锻炼与认知障碍之间关联的效应修正。
与未进行体育锻炼的老年人相比，进行体育锻炼的老年人在基线和随访时出现认知障碍的概率呈下降趋势（比值比分别为0.92，95%置信区间为0.80 - 1.06，P = 0.273；比值比为0.83，95%置信区间为0.65 - 1.05，P = 0.123）。按饮食习惯分层时，体育锻炼对食用水果的老年人（比值比为0.74，95%置信区间为0.58 - 0.94，P = 0.016）、食用豆类制品的老年人（比值比为0.76，95%置信区间为0.62 - 0.93，P = 0.007）、不食用糖的老年人（比值比为0.81，95%置信区间为0.68 - 0.98，P = 0.028）和食用奶制品的老年人（比值比为0.75，95%置信区间为0.57 - 0.97，P = 0.030）的现患认知障碍具有保护作用；在纵向分析中，体育锻炼对食用水果的老年人（比值比为0.63，95%置信区间为0.41 - 0.98，P = 0.040）和食用奶制品的老年人（比值比为0.57，95%置信区间为0.35 - 0.94，P = 0.027）的新发认知障碍具有保护作用。水果、豆类制品和奶制品改变了体育锻炼与现患认知障碍之间的关联（交互作用P值分别为0.008、0.005和0.082）。
体育锻炼与认知障碍之间的关联可能会受到某些饮食习惯的影响。除非社区居住的老年人具有特定的饮食习惯，否则未发现体育锻炼对其认知障碍具有显著的保护作用。因此，在调查体育锻炼对社区居住老年人认知功能的有益作用时，应强调饮食习惯。
