Postdoctoral Research Station in Basic Medicine, Hebei Medical University, Shijiazhuang, China.
School of Nursing, Centre for Gerontological Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
Front Public Health. 2022 Nov 22;10:1035762. doi: 10.3389/fpubh.2022.1035762. eCollection 2022.
Older adults with mild cognitive impairment (MCI) have the possibility of reverting to normal cognitive function. Leisure activity engagement (LAE) plays a critical role in the progress of the cognitive function. A better understanding of the dynamic relationship between LAE and MCI reversion would inform the implementation of preclinical dementia interventions. This study aimed to investigate the association between change patterns of LAE and MCI reversion among older adults using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database.
Longitudinal population-based study.
Older adults with MCI at the baseline were enrolled in this study. Information about cognitive function, overall, cognitively stimulating, physically active/demanding, and socially engaged LAE was collected at baseline and follow-up. Adjusted hazard ratios (HRs) for reversion and 95% confidence intervals (CIs) were calculated by Cox hazard models with time as the underlying time metric. We also assessed potential effect modifications by creating a cross-product of the stratifying variable with LAE change patterns in the fully adjusted model.
The restricted cubic spline showed that the association between LAE change scores and MCI reversion rate was statistically significant and nonlinear (<0.01). Taking participants in the low-low group as a reference, participants in the low-medium, low-high, medium-medium, medium-high, high-medium, and high-high groups had increased possibilities of MCI reversion with HRs (95% CI) of 2.19 (1.57-3.06), 2.97 (2.13-4.13), 0.87 (0.64-1.19), 2.28 (1.71-3.03), 2.78 (2.10-3.69), 1.93 (1.43-2.59), and 2.74 (2.09-3.60), respectively. Further stratified models showed that the impact of LAE change patterns on MCI reversion varied in different ages (nonagenarian, octogenarian, and younger elderly) and gender.
Participants who maintained the highest LAE had the greatest possibility of MCI reversion. Meanwhile, a higher level of LAE maintenance was associated with the increased possibility of MCI reversion. These results provide a practical message to older adults about how dynamic changes in LAE are associated with improved cognitive function.
轻度认知障碍（MCI）的老年人有可能恢复正常认知功能。休闲活动参与（LAE）在认知功能的进展中起着关键作用。更好地了解 LAE 与 MCI 逆转之间的动态关系将为实施临床前痴呆干预措施提供信息。本研究旨在使用中国长寿纵向研究（CLHLS）数据库，探讨老年人 LAE 变化模式与 MCI 逆转之间的关联。
纵向基于人群的研究。
本研究纳入了基线时患有 MCI 的老年人。在基线和随访时收集了认知功能、全面、认知刺激、身体活动/要求和社会参与 LAE 的信息。使用 Cox 风险模型计算了与时间作为基本时间指标的逆转调整后的风险比（HR）和 95%置信区间（CI）。我们还通过在完全调整模型中创建分层变量与 LAE 变化模式的交叉乘积来评估潜在的效应修饰。
限制三次样条显示，LAE 变化得分与 MCI 逆转率之间的关联具有统计学意义且呈非线性（<0.01）。以低-低组的参与者为参考，低-中、低-高、中-中、中-高、高-中、高-高组的 MCI 逆转可能性增加，HR（95%CI）分别为 2.19（1.57-3.06）、2.97（2.13-4.13）、0.87（0.64-1.19）、2.28（1.71-3.03）、2.78（2.10-3.69）、1.93（1.43-2.59）和 2.74（2.09-3.60）。进一步的分层模型显示，LAE 变化模式对 MCI 逆转的影响在不同年龄（90 岁以上、80 岁以上和年轻老年人）和性别中有所不同。
保持最高 LAE 的参与者最有可能恢复 MCI。同时，更高水平的 LAE 维持与 MCI 逆转的可能性增加有关。这些结果为老年人提供了一个实际信息，即 LAE 的动态变化如何与认知功能的改善相关。
