调查社会经济地位和生活方式因素对独立生活在社区中的意大利老年人轻度认知障碍的个体及联合影响：NutBrain研究结果

Investigating the individual and joint effects of socioeconomic status and lifestyle factors on mild cognitive impairment in older Italians living independently in the community: results from the NutBrain study.

作者信息

Bernini Sara, Conti Silvia, Perdixi Elena, Jesuthasan Nithiya, Costa Alfredo, Severgnini Marco, Ramusino Matteo Cotta, Prinelli Federica

机构信息

Clinical Neuroscience Unit of Dementia, Dementia Research Center, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; Neuropsychology Lab/Center for Cognitive Disorders and Dementia IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy.

Neuropsychology Lab/Center for Cognitive Disorders and Dementia IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy; Institute of Biomedical Technologies - National Research Council, Via Fratelli Cervi 93, 20054 Segrate, MI, Italy.

出版信息

J Nutr Health Aging. 2024 Mar;28(3):100040. doi: 10.1016/j.jnha.2024.100040. Epub 2024 Jan 26.

DOI:10.1016/j.jnha.2024.100040

PMID:38280834

Abstract

OBJECTIVES

Despite extensive research, a clear understanding of the role of the interaction between lifestyle and socioeconomic status (SES) on cognitive health is still lacking. We investigated the joint association of socioeconomic factors in early to midlife and lifestyle in later life and Mild Cognitive Impairment (MCI).

DESIGN

Observational cross-sectional study.

SETTING

NutBrain study in northern Italy.

PARTICIPANTS

773 community-dwelling adults aged 65 years and older (73.2 ± 6.0 SD, 58.6% females) participating in the NutBrain study (2019-2023).

MEASUREMENTS

Three SES indicators (home ownership, educational level, occupation) and five lifestyle factors (adherence to Mediterranean diet, physical activity, smoking habits, social network, leisure activities) were selected. Each factor was scored and summed to calculate SES and healthy lifestyle scores; their joint effect was also examined. The association with MCI was assessed by logistic regression controlling for potential confounders. Sex-stratified analysis was performed.

RESULTS

In total, 24% of the subjects had MCI. The multivariable logistic model showed that a high SES and a high lifestyle score were associated with 81.8% (OR0.182; 95%CI 0.095-0.351), and 44.1% (OR0.559; 95%CI 0.323-0.968) lower odds of having MCI, respectively. When examining the joint effect of SES and lifestyle factors, the cognitive benefits of a healthy lifestyle were most pronounced in participants with low SES. A healthier lifestyle score was found to be significantly associated with lower odds of MCI, only in females.

CONCLUSIONS

According to our findings, SES was positively associated with preserved cognitive function, highlighting the importance of active lifestyles in reducing socioeconomic health inequalities, particularly among those with a relatively low SES.

TRIAL REGISTRATION

Trial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).

摘要

目的

尽管进行了广泛研究，但仍缺乏对生活方式与社会经济地位（SES）之间的相互作用对认知健康作用的清晰理解。我们调查了中年早期至中期的社会经济因素与晚年生活方式及轻度认知障碍（MCI）之间的联合关联。

设计

观察性横断面研究。

地点

意大利北部的NutBrain研究。

参与者

773名年龄在65岁及以上的社区居住成年人（平均年龄73.2±6.0标准差，女性占58.6%）参与了NutBrain研究（2019 - 2023年）。

测量

选取了三个社会经济地位指标（住房所有权、教育水平、职业）和五个生活方式因素（坚持地中海饮食、体育活动、吸烟习惯、社交网络、休闲活动）。对每个因素进行评分并求和，以计算社会经济地位和健康生活方式得分；还检验了它们的联合效应。通过对潜在混杂因素进行控制的逻辑回归评估与MCI的关联。进行了性别分层分析。

结果

总共24%的受试者患有MCI。多变量逻辑模型显示，高社会经济地位和高生活方式得分分别与患MCI的几率降低81.8%（OR0.182；95%CI 0.095 - 0.351）和44.1%（OR0.559；95%CI 0.323 - 0.968）相关。在考察社会经济地位和生活方式因素的联合效应时，健康生活方式对认知的益处在社会经济地位低的参与者中最为明显。仅在女性中发现更健康的生活方式得分与较低的MCI几率显著相关。