Li Wei, Li Yong, Chen Yaopian, Yue Ling, Xiao Shifu
Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
Front Aging Neurosci. 2022 Aug 23;14:975329. doi: 10.3389/fnagi.2022.975329. eCollection 2022.
Previous studies have confirmed that physical exercise may be beneficial for brain health, but there is little data on this among older Chinese.
The purpose of this study was to explore the relationship between physical exercise and cognitive impairment, and to explore the possible mechanism by which physical exercise prevents cognitive decline.
192 older adults with dementia, 610 older adults with mild cognitive impairment (MCI), and 2,218 healthy older adults were included in the study. Through standardized questionnaires, we obtained their general demographic information (such as gender, age, education, etc.), disease-related information (hypertension and diabetes) and physical exercise information (such as whether they did physical exercise and the frequency of physical exercise, etc.). The mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess their overall cognitive function, while the Wechsler block diagram was used to assess their executive function. Moreover, 164 healthy, randomly selected older adults also underwent brain MRI scans at the same time, and the target brain regions included hippocampus, gray matter, and cerebellar cortex.
By using stepwise multiple logistics regression analysis, we found that physical exercise was associated with both MCI ( = 0.001*, = 0.689, 95%CI: 0.553-0.859) and dementia ( < 0.001*, = 0.501, 95%CI: 0.354-0.709), independent of gender, age, education, and other factors. The results of ROC curve showed that the area under the curve of physical exercise in predicting MCI and dementia was 0.551 ( < 0.001*, 95%CI: 0.525-0.577) and 0.628 ( = 0.001*, 95%CI: 0.585-0.671), respectively. The results of partial correlation analysis showed that physical exercise was associated with left cerebellar cortex ( = 0.163, = 0.023), right cerebellar cortex ( = 0.175, = 0.015) and Wechsler block diagram score ( = 0.235, = 0.011). Moreover, the results of linear regression analysis mediation model showed that physical exercise may affect Wechsler block diagram score through influencing the thickness of right cerebellum cortex, and the latter may play a partial mediation effect (indirect = 0.001, = 0.045).
Physical exercise might be a protective factor for mild cognitive impairment and dementia among the Chinese elderly, and there might be an association among physical exercise, executive function, and the thickness of the cerebellar cortex.
先前的研究已证实体育锻炼可能有益于大脑健康，但在中国老年人中关于此方面的数据较少。
本研究旨在探讨体育锻炼与认知障碍之间的关系，并探究体育锻炼预防认知衰退的可能机制。
本研究纳入了192名患有痴呆症的老年人、610名患有轻度认知障碍（MCI）的老年人以及2218名健康老年人。通过标准化问卷，我们获取了他们的一般人口统计学信息（如性别、年龄、教育程度等）、疾病相关信息（高血压和糖尿病）以及体育锻炼信息（如是否进行体育锻炼以及体育锻炼的频率等）。采用简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）评估他们的整体认知功能，同时使用韦氏木块图评估他们的执行功能。此外，随机选取的164名健康老年人也同时接受了脑部MRI扫描，目标脑区包括海马体、灰质和小脑皮质。
通过逐步多元逻辑回归分析，我们发现体育锻炼与MCI（ = 0.001*， = 0.689，95%CI：0.553 - 0.859）和痴呆症（ < 0.001*， = 0.501，95%CI：0.354 - 0.709）均相关，且独立于性别、年龄、教育程度和其他因素。ROC曲线结果显示，体育锻炼在预测MCI和痴呆症时的曲线下面积分别为0.551（ < 0.001*，95%CI：0.525 - 0.577）和0.628（ = 0.001*，95%CI：0.585 - 0.671）。偏相关分析结果显示，体育锻炼与左侧小脑皮质（ = 0.163， = 0.02）、右侧小脑皮质（ = 0.175， = 0.015）以及韦氏木块图评分（ = 0.235， = 0.011）相关。此外，线性回归分析中介模型结果显示，体育锻炼可能通过影响右侧小脑皮质厚度来影响韦氏木块图评分，且后者可能起部分中介作用（间接 = 0.001， = 0.045）。
体育锻炼可能是中国老年人轻度认知障碍和痴呆症的保护因素，并且体育锻炼、执行功能和小脑皮质厚度之间可能存在关联。
