Wang Xin, Bakulski Kelly M, Paulson Henry L, Albin Roger L, Park Sung Kyun
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA, 48109.
Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, Michigan, USA, 48109.
medRxiv. 2023 Jan 28:2023.01.24.23284961. doi: 10.1101/2023.01.24.23284961.
We investigated the complex relations of socioeconomic status (SES) and healthy lifestyles with cognitive functions among older adults in 1,313 participants, aged 60 years and older, from the National Health and Nutrition Examination Survey 2011-2014. Cognitive function was measured using an average of the standardized z-scores of the Consortium to Establish a Registry for Alzheimer’s Disease Word Learning and delayed recall tests, the Animal Fluency Test, and the Digit Symbol Substitution Test. Latent class analysis of family income, education, occupation, health insurance, and food security was used to define composite SES (low, medium, high). A healthy lifestyle score was calculated based on smoking, alcohol consumption, physical activity, and the Healthy-Eating-Index-2015. In survey-weighted multivariable linear regressions, participants with 3 or 4 healthy behaviors had 0.07 (95% CI: 0.005, 0.14) standard deviation higher composite cognitive z-score, relative to those with one or no healthy behavior. Participants with high SES had 0.37 (95% CI: 0.29, 0.46) standard deviation higher composite cognitive z-score than those with low SES. No statistically significant interaction was observed between healthy lifestyle score and SES. Our findings suggested that higher healthy lifestyle scores and higher SES were associated with better cognitive function among older adults in the United States.
我们对2011 - 2014年美国国家健康与营养检查调查中1313名60岁及以上老年人的社会经济地位（SES）、健康生活方式与认知功能之间的复杂关系进行了调查。认知功能通过阿尔茨海默病注册协会单词学习和延迟回忆测试、动物流畅性测试以及数字符号替换测试的标准化z分数平均值来衡量。通过对家庭收入、教育程度、职业、健康保险和食品安全进行潜在类别分析来定义综合社会经济地位（低、中、高）。基于吸烟、饮酒、身体活动和2015年健康饮食指数计算健康生活方式得分。在调查加权多变量线性回归中，与有1种或没有健康行为的参与者相比，有3种或4种健康行为的参与者综合认知z分数高出0.07（95%置信区间：0.005，0.14）个标准差。社会经济地位高的参与者比社会经济地位低的参与者综合认知z分数高出0.37（95%置信区间：0.29，0.46）个标准差。未观察到健康生活方式得分与社会经济地位之间存在统计学上的显著交互作用。我们的研究结果表明，在美国老年人中，较高的健康生活方式得分和较高的社会经济地位与较好的认知功能相关。
