Li Xin, Jin Yichen, Bandinelli Stefania, Ferrucci Luigi, Tanaka Toshiko, Talegawkar Sameera A
Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Geriatric Unit, USL Toscana Centro Firenze, Florence, Italy.
J Am Geriatr Soc. 2024 Dec;72(12):3695-3704. doi: 10.1111/jgs.19194. Epub 2024 Sep 18.
Dementia poses considerable challenges to healthy aging. Prevention and management of dementia are essential given the lack of effective treatments for this condition.
A secondary data analysis was conducted using data from 928 InCHIANTI study participants (55% female) aged 65 years and older without dementia at baseline. Cardiovascular health (CVH) was assessed by the "Life's Essential 8" (LE8) metric that included health behaviors (diet, physical activity, smoking status, sleep duration) and health factors (body mass index, blood lipid, blood glucose, blood pressure). This new LE8 metric scores from 0 to 100, with categorization including "low LE8" (0-49), indicating low CVH, "moderate LE8 (50-79)", indicating moderate CVH, and "high LE8 (80-100)", indicating high CVH. Dementia was ascertained by a combination of neuropsychological testing and clinical assessment at each follow-up visit. Cox proportional hazards models were used to examine associations between CVH at baseline and risk of incident dementia after a median follow-up of 14 years.
Better CVH (moderate/high LE8 vs. low LE8) was inversely associated with the risk of incident dementia (hazard ratio [HR]: 0.61, 95% confidence interval [CI]: 0.46-0.83, p = 0.001). Compared with health factors, higher scores of the health behaviors (per 1 standard deviation [SD]), specifically weekly moderate-to-vigorous physical activity time (per 1 SD), were significantly associated with a lower risk of incident dementia (health behaviors: HR:0.84, CI:0.73-0.96, p = 0.01; physical activity: HR: 0.62, CI: 0.53-0.72, p < 0.001).
While longitudinal studies with repeated measures of CVH are needed to confirm these findings, improving CVH, measured by the LE8 metric, may be a promising dementia prevention strategy.
痴呆症给健康老龄化带来了巨大挑战。鉴于目前缺乏针对这种疾病的有效治疗方法，痴呆症的预防和管理至关重要。
利用来自928名年龄在65岁及以上、基线时无痴呆症的InCHIANTI研究参与者（55%为女性）的数据进行二次数据分析。心血管健康（CVH）通过“生命必需的8项指标”（LE8）进行评估，该指标包括健康行为（饮食、体育活动、吸烟状况、睡眠时间）和健康因素（体重指数、血脂、血糖、血压）。这个新的LE8指标得分从0到100，分类包括“低LE8”（0 - 49），表示心血管健康水平低；“中等LE8（50 - 79）”，表示心血管健康水平中等；“高LE8（80 - 100）”，表示心血管健康水平高。在每次随访时，通过神经心理学测试和临床评估相结合的方式确定是否患有痴呆症。使用Cox比例风险模型来研究基线时的心血管健康与中位随访14年后发生痴呆症风险之间的关联。
更好的心血管健康（中等/高LE8与低LE8相比）与发生痴呆症的风险呈负相关（风险比[HR]：0.61，95%置信区间[CI]：0.46 - 0.83，p = 0.001）。与健康因素相比，健康行为得分较高（每增加1个标准差[SD]），特别是每周中等至剧烈体育活动时间（每增加1个标准差），与发生痴呆症的风险显著降低相关（健康行为：HR：0.84，CI：0.73 - 0.96，p = 0.01；体育活动：HR：0.62，CI：0.53 - 0.72，p < 0.001）。
虽然需要通过对心血管健康进行重复测量的纵向研究来证实这些发现，但以LE8指标衡量，改善心血管健康可能是一种有前景的痴呆症预防策略。
