Xu Minzhi, Zhou Ying, Yan Qin, Ke Pan, Yin Xiaoxv, Gong Yanhong
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Affect Disord. 2023 Apr 14;327:362-367. doi: 10.1016/j.jad.2023.02.026. Epub 2023 Feb 9.
To investigate whether the effects of leisure activities on cognition differ among socioeconomic groups and the effects of changes in the frequency of habitual leisure activities on cognition.
We included 5869 older adults from the Chinese Longitudinal Healthy Longevity Survey (2008-2014). Five typical leisure activities were used to calculate the Leisure Activity Index (LAI). The Mini-Mental State Examination was used to assess cognition. Latent class analysis was used to construct the overall socioeconomic status (SES). Cox proportional hazard regression was applied to explore the associations and further stratified the analysis by SES.
Participants in the highest quartile of LAI had a 50 % lower risk of developing cognitive impairment compared with the lowest quartile of LAI (HR: 0.50, 95 % CI: 0.40-0.62) (P < 0.01). Compared with participants who participated in leisure activities with increased frequency during the follow-up period, the HR (95 % CIs) of participants with no change in frequency was 3.10 (2.39-4.01), and that of participants with decreased frequency was 2.34 (1.81-3.04). A significant interaction between LAI and SES were found (P = 0.02). The association between LAI and cognitive function was more pronounced in participants with high SES (HR: 0.31, 95 % CI: 0.16-0.59) than in participants with low SES (HR: 0.61, 95 % CI: 0.45-0.83).
Leisure activities may have significant benefits in preventing cognitive impairment. However, promoting leisure activities alone may not substantially reduce socioeconomic inequalities in cognitive health. Measures addressing the social determinants of cognitive health still need to be further explored.
探讨休闲活动对认知的影响在社会经济群体中是否存在差异，以及习惯性休闲活动频率的变化对认知的影响。
我们纳入了中国老年健康长寿纵向调查（2008 - 2014年）中的5869名老年人。使用五项典型的休闲活动来计算休闲活动指数（LAI）。采用简易精神状态检查表评估认知功能。使用潜在类别分析构建总体社会经济地位（SES）。应用Cox比例风险回归来探索关联，并按社会经济地位进一步分层分析。
与LAI最低四分位数的参与者相比，LAI最高四分位数的参与者发生认知障碍的风险降低了50%（风险比：0.50，95%置信区间：0.40 - 0.62）（P < 0.01）。与在随访期间参与休闲活动频率增加的参与者相比，频率无变化的参与者的风险比（95%置信区间）为3.10（2.39 - 4.01），频率降低的参与者的风险比为2.34（1.81 - 3.04）。发现LAI与社会经济地位之间存在显著交互作用（P = 0.02）。高社会经济地位参与者中LAI与认知功能之间的关联比低社会经济地位参与者更明显（风险比：0.31，95%置信区间：0.16 - 0.59）（风险比：0.61，95%置信区间：0.45 - 0.83）。
休闲活动在预防认知障碍方面可能具有显著益处。然而，仅促进休闲活动可能无法大幅减少认知健康方面的社会经济不平等。仍需进一步探索解决认知健康社会决定因素的措施。
