Du Litao, Li Ting, Xue Xiangli, He Qiang, Pan Yang, Chen Si, Zhang Xianliang
School of Physical Education, Shandong University, Jinan, China.
School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.
Gen Hosp Psychiatry. 2024 Nov-Dec;91:52-59. doi: 10.1016/j.genhosppsych.2024.09.003. Epub 2024 Sep 8.
This study aims to explore the independent and joint association of physical activity (PA) and inflammatory diet with cognitive function in aging.
Data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) was used. 2249 NHANES participants with valid data represented a weighted population of 50.5 million American residents aged 60 and older. This study separately analyzed the independent associations of PA (measured by global physical activity questionnaire) and inflammatory diet (measured by energy-adjusted dietary inflammatory index from 24-h dietary recall), and their joints (inactive & pro-inflammatory as reference) with cognitive function (assessed by three cognitive tests), and considered an individual of different status and non-linear effect by sub-group and restricted cubic splines (RCS) analysis, respectively. All analysis was multivariable-adjusted and sample-weighted.
The results showed that inflammatory diet was independently associated with lower cognitive function, with a 1.08, 1.29, 2.67, 0.56 lower score in the Registry for Alzheimer's Disease word list learning test (CERAD), the Animal Fluency Test (AFT), the Digit Symbol Substitution test (DSST), Z-scores, and 51 %, 62 %, 63 %, 93 % higher odds ratio (OR) of lower performance in CERAD, AFT, DSST, and p-MCI, respectively. PA was independently associated with higher cognitive function, with a 1.41, 3.37, and 0.52 higher score in AFT, DSST, Z-scores, and 28 %, 51 %, 41 % lower ORs of lower performance in CERAD and DSST and p-MCI, respectively. Active & Anti-inflammatory was always positively associated with cognitive function, with a 1.42, 2.69, 5.47, and 1.04 higher score for CERAD, AFT, DSST, and Z-score, a 58 %, 56 %, 74 %, 76 % lower ORs of lower performance in CERAT, AFT, DSST, and p-MCI, respectively, which elicited the maximum compared to other joints.
Adhering to both active PA and anti-inflammatory diet is recommended for cognitive management in older adults. Sticking to either active PA or anti-inflammatory diet also shows potential cognitive benefits, with the diet possibly playing more vital role.
本研究旨在探讨身体活动（PA）和炎症性饮食与衰老过程中认知功能的独立关联和联合关联。
使用2011 - 2014年美国国家健康与营养检查调查（NHANES）的数据。2249名有有效数据的NHANES参与者代表了5050万年龄在60岁及以上的美国居民的加权总体。本研究分别分析了PA（通过全球身体活动问卷测量）和炎症性饮食（通过24小时饮食回忆的能量调整饮食炎症指数测量）及其联合情况（以不活动和促炎为参照）与认知功能（通过三项认知测试评估）的独立关联，并分别通过亚组分析和受限立方样条（RCS）分析考虑个体的不同状态和非线性效应。所有分析均进行了多变量调整和样本加权。
结果显示，炎症性饮食与较低的认知功能独立相关，在阿尔茨海默病词汇表学习测试（CERAD）、动物流畅性测试（AFT）、数字符号替换测试（DSST）中的得分分别低1.08、1.29、2.67、0.56，Z分数分别低0.56，在CERAD、AFT、DSST和轻度认知障碍（p - MCI）中表现较差的优势比（OR）分别高51%、62%、63%、93%。PA与较高的认知功能独立相关，在AFT、DSST、Z分数中的得分分别高1.41、3.37、0.52，在CERAD、DSST和p - MCI中表现较差的OR分别低28%、51%、41%。活跃且抗炎状态始终与认知功能呈正相关，在CERAD、AFT、DSST和Z分数中的得分分别高1.42、2.69、5.47、1.04，在CERAT、AFT、DSST和p - MCI中表现较差的OR分别低58%、56%、74%、76%，与其他联合情况相比，这种情况的效果最为显著。
建议老年人在认知管理方面坚持积极的身体活动和抗炎饮食。坚持积极的身体活动或抗炎饮食也显示出潜在的认知益处，饮食可能发挥更重要的作用。
