Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
BMC Geriatr. 2023 Feb 6;23(1):79. doi: 10.1186/s12877-023-03761-0.
Frailty describes an age-related state of deterioration in biological function. This study aimed to investigate the association between frailty and cognitive function and its combined effects with lifestyles.
A total of 3,279 participants from the Dongfeng-Tongji (DFTJ) cohort were tested the cognitive function by using the Chinese version of Mini-mental State Examination (MMSE). Frailty was evaluated based on a 35-item frailty index (FI). Frailty status was dichotomized into robust (FI < 0.15) and frail (FI ≥ 0.15). Multivariate generalized linear regression models and logistic regression models were used to estimate the associations of frailty with MMSE score and cognitive impairment. We also analysed the modification and combined effects of lifestyle factors, including smoking status, drinking status, and regular physical exercise, on the above associations.
FI was significantly associated with lower MMSE score [β (95%Cl) = -0.28 (-0.43, -0.13)] and cognitive impairment [OR (95%Cl) = 1.19 (1.04, 1.35)]. The association of frailty status with MMSE were found to be stronger among ever smokers [β(95%Cl) = -1.08 (-1.64, -0.51)] and physical inactive individuals [β(95%Cl) = -1.59 (-2.63, -0.54)] while weaker or not significant among never smokers [β(95%Cl) = -0.30 (-0.62, 0.01)] and physical active individuals [β(95%Cl) = -0.37 (-0.65, -0.08))]. There were significant combined effects of frailty status with unhealthy lifestyles including smoking, alcohol drinking, and physical inactive on cognitive impairment.
Frailty was associated with cognitive impairment among Chinese middle-aged and elderly people, while smoking cessation and regular physical exercise could attenuate the above associations, which highlight the potential preventive interventions.
衰弱描述了一种与年龄相关的生物功能恶化状态。本研究旨在探讨衰弱与认知功能之间的关联及其与生活方式的综合影响。
共有 3279 名来自东风-同济（DFTJ）队列的参与者接受了中文版简易精神状态检查（MMSE）的认知功能测试。根据 35 项衰弱指数（FI）评估衰弱状况。将衰弱状况分为健壮（FI<0.15）和衰弱（FI≥0.15）两类。采用多变量广义线性回归模型和逻辑回归模型来估计衰弱与 MMSE 评分和认知障碍的相关性。我们还分析了包括吸烟状况、饮酒状况和定期体育锻炼在内的生活方式因素对上述关联的修饰和综合影响。
FI 与较低的 MMSE 评分[β（95%CI）=-0.28（-0.43，-0.13）]和认知障碍[OR（95%CI）=1.19（1.04，1.35）]显著相关。在曾经吸烟的人群中，衰弱状况与 MMSE 的相关性更强[β（95%CI）=-1.08（-1.64，-0.51）]，在不活跃的个体中更强[β（95%CI）=-1.59（-2.63，-0.54）]，而在从不吸烟的人群中较弱或不显著[β（95%CI）=-0.30（-0.62，0.01）]，在活跃的个体中较弱或不显著[β（95%CI）=-0.37（-0.65，-0.08）]。衰弱状况与不健康的生活方式（包括吸烟、饮酒和不活跃）之间存在显著的综合影响，与认知障碍有关。
在中国中老年人群中，衰弱与认知障碍有关，而戒烟和定期体育锻炼可以减轻上述关联，这突出了潜在的预防干预措施。
