Medical School, Postgraduate Program in Environmental Health, Metropolitan University of Santos (UNIMES), Santos, SP, Brazil.
Department of Biosciences, Institute of Health and Society, Federal University of Sao Paulo (UNIFESP), Santos, SP, Brazil.
J Alzheimers Dis. 2022;90(2):859-867. doi: 10.3233/JAD-220517.
Modifiable risk factors exert crucial impact on dementia.
We sought to answer the question: do two modifiable risk factors, schooling level and physical activity (PA), affect cognitive function similarly in each sex?
This cross-sectional study was conducted in 2019 and 2021, and the survey was applied to the residents of the metropolitan area of Santos, a seashore of Sao Paulo State. Four hundred and twenty-two participants (women = 254 and men = 168) were eligible. Baecke questionnaire for the elderly was applied for the classification as physically inactive (PI) or active (PA). Cognitive function was assessed by the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR). Participants were also stratified by schooling status for both sexes.
Higher education had a sex-independent positive influence on MMSE and CDR (p < 0.001). PA influences positively MMSE in older women (PI: 25±5 and PA: 27±3, p < 0.03), but has no effect in older men (26±5 and 25±5, p > 0.05). Concordantly, older women who were PA (1.7 and 0 %) showed a lower prevalence of dementia compared with PI (6.2 and 2.1%), for mild and moderate respectively. Active older women had higher odds of improving the MMSE score (OR: 1.093; 95% CI: 1.008-1.186) than men (OR: 0.97 (95% CI: 0.896-1.051).
Education affects cognitive function equally in Brazilian elderly whereas older women are more responsive to the beneficial effects of PA for dementia than men.
可改变的风险因素对痴呆症有重要影响。
我们试图回答这个问题：两个可改变的风险因素，教育程度和身体活动（PA），是否对男性和女性的认知功能有相同的影响？
这是一项 2019 年至 2021 年进行的横断面研究，调查对象为圣保罗州海滨城市桑托斯大都市区的居民。共有 422 名参与者（女性 254 名，男性 168 名）符合条件。采用 Baecke 老年问卷对老年人进行分类，分为不活跃（PI）或活跃（PA）。认知功能通过简易精神状态检查（MMSE）和临床痴呆评定量表（CDR）进行评估。还按性别对参与者的受教育程度进行了分层。
较高的教育程度对 MMSE 和 CDR 有独立于性别的积极影响（p<0.001）。PA 对老年女性的 MMSE 有积极影响（PI：25±5 和 PA：27±3，p<0.03），但对老年男性没有影响（26±5 和 25±5，p>0.05）。同样，PA 的老年女性（1.7%和 0%）患轻度和中度痴呆的比例分别低于 PI（6.2%和 2.1%）。与男性相比（OR：0.97（95%CI：0.896-1.051）），PA 的老年女性更有可能提高 MMSE 评分（OR：1.093；95%CI：1.008-1.186）。
在巴西老年人中，教育程度对认知功能的影响是平等的，而老年女性对 PA 对痴呆症的有益影响比男性更敏感。
