老年人的血清阳性率与认知功能：对 2011-2014 年全国健康和营养调查的横断面数据分析。
seropositivity and cognitive functioning in older adults: an analysis of cross-sectional data of the National Health and Nutrition Examination Survey 2011-2014.
机构信息
College of Sciences and Technology, University of Houston Downtown, Houston, Texas, USA.
School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
出版信息
BMJ Open. 2024 Mar 5;14(3):e071513. doi: 10.1136/bmjopen-2022-071513.
OBJECTIVES
This study sought to examine the relationship between seropositivity and cognitive function in older adults.
DESIGN
An observational cross-sectional study.
SETTING
The National Health and Nutrition Examination Survey (NHANES) study took place at participants' homes and mobile examination centres.
PARTICIPANTS
A total of 2956 older adults aged 60 and above from the NHANES from 2011 to 2014 were included in the study. Exposure of interest: participants had serum antibody analysed in the laboratory. A value>33 IU/mL was categorised as seropositive for infection; <27 IU/mL was categorised as seronegative for infection.
PRIMARY AND SECONDARY OUTCOME MEASURES
Cognitive tests included the Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL) for immediate and delayed memory, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST).
RESULTS
About half of the 2956 participants (mean age 70.0) were female (51.0%), non-Hispanic White (48.3%), and completed some college or above (48.3%). A total of 703 participants were positive for infection (23.8%). Adjusted linear regression showed that compared with participants with negative infection, those with positive infection had lower CERAD-WL immediate memory (beta (β) -0.16, 95% CI -0.25 to -0.07), CERAD-WL delayed memory (β -0.15, 95% CI -0.24 to -0.06), AFT (β -0.15, 95% CI -0.24 to -0.06), DSST (β -0.34, 95% CI -0.43 to -0.26), and global cognition (β -0.24, 95% CI -0.32 to -0.16) z-scores after controlling for the covariates.
CONCLUSIONS
seropositivity is associated with worse immediate and delayed verbal learning, language proficiency, executive functioning, processing speed, sustained attention, working memory, as well as global cognition in older adults. Public health measures aiming at preventing infection may help preserve cognitive functioning in older adults.
目的
本研究旨在探讨老年人血清阳性与认知功能之间的关系。
设计
观察性横断面研究。
地点
国家健康和营养检查调查（NHANES）研究在参与者的家中和移动检查中心进行。
参与者
共纳入 2011 年至 2014 年 NHANES 中 2956 名年龄在 60 岁及以上的老年人。感兴趣的暴露因素：实验室分析了参与者的血清抗体。血清抗体>33IU/ml 归类为 感染阳性；血清抗体<27IU/ml 归类为 感染阴性。
主要和次要结局测量
认知测试包括 Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest（CERAD-WL）即时记忆和延迟记忆、动物流畅性测试（AFT）和数字符号替换测试（DSST）。
结果
2956 名参与者中约有一半（平均年龄 70.0 岁）为女性（51.0%）、非西班牙裔白人（48.3%），并完成了一些大学或以上的学业（48.3%）。共有 703 名参与者感染呈阳性（23.8%）。调整后的线性回归显示，与感染阴性的参与者相比，感染阳性的参与者 CERAD-WL 即时记忆（β-0.16，95%CI-0.25 至-0.07）、CERAD-WL 延迟记忆（β-0.15，95%CI-0.24 至-0.06）、AFT（β-0.15，95%CI-0.24 至-0.06）、DSST（β-0.34，95%CI-0.43 至-0.26）和全球认知（β-0.24，95%CI-0.32 至-0.16）得分较低，调整协变量后。
结论
血清阳性与老年人即时和延迟言语学习、语言能力、执行功能、处理速度、持续注意力、工作记忆以及整体认知能力下降有关。旨在预防 感染的公共卫生措施可能有助于保持老年人的认知功能。
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