加拿大老龄化纵向研究中按年龄和性别划分的衰弱与执行功能之间的关系。
Relationship between frailty and executive function by age and sex in the Canadian Longitudinal Study on Aging.
作者信息
Courish Molly K, O'Brien Myles W, Maxwell Selena P, Mekari Said, Kimmerly Derek S, Theou Olga
机构信息
Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
Geriatric Medicine Research, Dalhousie University & Nova Scotia Health, Halifax, NS, Canada.
出版信息
Geroscience. 2025 Feb;47(1):1049-1060. doi: 10.1007/s11357-024-01256-3. Epub 2024 Jul 17.
Frailty reflects age-related damage to multiple physiological systems. Executive dysfunction is often a presenting symptom of diseases characterized by cognitive impairment. A decline in cardiovascular health is associated with worse executive function. We tested the hypothesis that higher frailty would be associated with executive dysfunction and that cardiovascular health would mediate this relationship. Middle- and older-aged adults at baseline (n = 29,591 [51% female]) and 3-year follow-up (n = 25,488 [49% females]) from the Canadian Longitudinal Study on Aging (comprehensive cohort) were included. Frailty was determined at baseline from a 61-item index, a cumulative cardiovascular health score was calculated from 30 variables at baseline, and participants completed a word-color Stroop task as an assessment of executive function. Multiple linear regressions and mediation analyses of cardiovascular health were conducted between frailty, Stroop interference-condition reaction time, and cardiovascular health in groups stratified by both age and sex (middle-aged males [MM], middle-aged females [MF], older-aged males [OM], older-aged females [OF]). Frailty (MM, 0.15 ± 0.05; MF, 0.16 ± 0.06; OM, 0.21 ± 0.06; OF, 0.23 ± 0.06) was negatively associated with cardiovascular health (MM, 0.12 ± 0.08; MF, 0.11 ± 0.07; OM, 0.20 ± 0.10; OF, 0.18 ± 0.09; β > 0.037, p < 0.001), as well as the Stroop reaction time at 3-year follow-up (MM, 23.7 ± 7.9; MF, 23.1 ± 7.3; OM, 32.9 ± 13.1; OF, 30.9 ± 12.0; β > 2.57, p < 0.001) across all groups when adjusted for covariates. Cardiovascular health was a partial (~ 10%) mediator between frailty and reaction time, aside from MFs. In conclusion, higher frailty levels are associated with executive dysfunction, which was partially mediated by cardiovascular health. Strategies to improve frailty and better cardiovascular health may be useful for combatting the age-related decline in executive function.
衰弱反映了与年龄相关的多个生理系统损伤。执行功能障碍通常是认知障碍相关疾病的一个表现症状。心血管健康状况下降与更差的执行功能相关。我们检验了这样一个假设：更高的衰弱程度会与执行功能障碍相关，且心血管健康状况会介导这种关系。纳入了来自加拿大衰老纵向研究（综合队列）基线期（n = 29591[51%为女性]）和3年随访期（n = 25488[49%为女性]）的中老年成年人。在基线期根据一个61项指标确定衰弱程度，根据30个基线变量计算累积心血管健康评分，参与者完成一项文字 - 颜色斯特鲁普任务作为执行功能的评估。在按年龄和性别分层的组（中年男性[MM]、中年女性[MF]、老年男性[OM]、老年女性[OF]）中，对衰弱、斯特鲁普干扰条件反应时间和心血管健康进行了多元线性回归及心血管健康的中介分析。在调整协变量后，衰弱（MM，0.15±0.05；MF，0.16±0.06；OM，0.21±0.06；OF，0.23±0.06）与心血管健康（MM，0.12±0.08；MF，0.11±0.07；OM，0.20±0.10；OF，0.18±0.09；β>0.037，p<0.001）以及3年随访时的斯特鲁普反应时间（MM，23.7±7.9；MF，23.1±7.3；OM，32.9±13.1；OF，30.9±12.0；β>2.57，p<0.001）在所有组中均呈负相关。除了中年女性外，心血管健康是衰弱与反应时间之间的部分（约10%）中介因素。总之，更高的衰弱水平与执行功能障碍相关，且这种关系部分由心血管健康介导。改善衰弱状况和更好的心血管健康的策略可能有助于对抗与年龄相关的执行功能衰退。
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