Cai Xiao-Ye, Qian Guo-Ping, Wang Feng, Zhang Ming-Yang, Da Ying-Juan, Liang Jing-Hong
Department of Physical Education, Shanghai Normal University Tianhua College, Shanghai, China.
Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdańsk, Poland.
Front Neurosci. 2023 Aug 4;17:1221990. doi: 10.3389/fnins.2023.1221990. eCollection 2023.
Existing evidence on the association between sedentary behavior (SB) and cognitive function remains inconclusive. Therefore, this study investigated the association between SB and the risk of cognitive decline (CD) or mild cognitive impairment (MCI) in the elderly.
A comprehensive search was independently conducted by two researchers (XC and GQ) in seven electronic databases, including Medline (via PubMed), China Biology Medicine, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang database, and VIP database for Chinese technical periodicals, covering studies published from the inception of database to June 2023. Studies that investigated the relationship between SB and the risk of CD or MCI in the elderly were included. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) assessment tools. The combined effect size analysis, subgroup analysis, and publication bias assessment were performed using STATA 14.0.
A total of 13 cross-sectional and 6 cohort studies involving 81,791 individuals were included, comprising 17 high-quality studies and 2 medium-quality studies. We found that SB was significantly associated with an increased risk of CD [odds ratio (OR) = 1.69, 95% confidence intervals (CI): 1.47-1.94] or MCI (OR = 1.34, 95% CI: 1.14-1.56) among the elderly. Subgroup analysis stratified according to comorbidity, lifestyle, family structure, publication year, and region showed statistical differences between groups, and the consistency of the results revealed the sources of the heterogeneity.
This meta-analysis showed that SB is positively associated with the risk of CD or MCI in the elderly, providing a higher level of evidence for the promotion of healthy behaviors by clinicians and health policymakers. Due to the number and quality of the included articles, more high-quality longitudinal studies are needed to further confirm our findings.
关于久坐行为（SB）与认知功能之间关联的现有证据尚无定论。因此，本研究调查了老年人中SB与认知衰退（CD）或轻度认知障碍（MCI）风险之间的关联。
两名研究人员（XC和GQ）独立在七个电子数据库中进行全面检索，包括Medline（通过PubMed）、中国生物医学文献数据库、Embase、科学引文索引、中国知网、万方数据库和维普中文科技期刊数据库，涵盖从数据库创建到2023年6月发表的研究。纳入调查老年人中SB与CD或MCI风险之间关系的研究。使用纽卡斯尔-渥太华量表（NOS）和医疗保健研究与质量局（AHRQ）评估工具对文献质量进行评估。使用STATA 14.0进行合并效应量分析、亚组分析和发表偏倚评估。
共纳入13项横断面研究和6项队列研究，涉及81,791名个体，其中包括17项高质量研究和2项中等质量研究。我们发现，在老年人中，SB与CD风险增加[比值比（OR）=1.69，95%置信区间（CI）：1.47-1.94]或MCI（OR =1.34，95%CI：1.14-1.56）显著相关。根据合并症、生活方式、家庭结构、发表年份和地区进行分层的亚组分析显示组间存在统计学差异，结果的一致性揭示了异质性的来源。
这项荟萃分析表明，SB与老年人CD或MCI风险呈正相关，为临床医生和卫生政策制定者促进健康行为提供了更高水平的证据。由于纳入文章的数量和质量，需要更多高质量的纵向研究来进一步证实我们的发现。
