Zhang Hao Ran, Wu Jia Wei, Wang Lecong, Ye Ming Zhu, Zheng Guo Hua
Department of Physical Education, Shanghai University of Medicine and Health Sciences, Shanghai, China.
College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, China.
Exp Aging Res. 2025 May-Jun;51(3):364-376. doi: 10.1080/0361073X.2024.2409587. Epub 2024 Oct 6.
The aim of this study was to investigate the mediating effect of cognitive reserve (CR) on the association between physical activity and cognitive function in community-dwelling older adults. A total of 495 community-dwelling older adults were included in this cross-sectional study. The CR, cognitive function, physical activity, and the potential confounders were assessed. Regression and bootstrap analyses were used to explore the mediating role of CR in physical activity and cognitive function. Compared to older adults with low to moderate physical activity, older adults with high physical activity had significantly better global cognitive function (βMoCA scores = 1.22, 95% CI 0.41 ~ 2.04) and visual spatial function (βCDT scores = 0.52, 95% CI 0.11 ~ 0.94) after adjustment for the confounders. CR mediated the association between physical activity and cognitive function with an indirect effect for global cognitive function (βMoCAscores = -0.29, 95% CI -0.56 ~ -0.09) and visual spatial function (βCDTscores = -0.14, 95% CI -0.28 ~ -0.05) after adjusting for the confounders, with 23.8% and 26.7% as percentage of mediation, respectively. These findings suggest that high physical activity could be effective in increasing cognitive reserve and preserving or improving cognitive function in community-dwelling older adults.
本研究旨在探讨认知储备（CR）在社区居住老年人身体活动与认知功能之间关联中的中介作用。本横断面研究共纳入了495名社区居住老年人。对认知储备、认知功能、身体活动及潜在混杂因素进行了评估。采用回归分析和Bootstrap分析来探究认知储备在身体活动与认知功能中的中介作用。与身体活动水平低至中等的老年人相比，身体活动水平高的老年人在调整混杂因素后，其整体认知功能（β蒙特利尔认知评估量表得分 = 1.22，95%置信区间0.41至2.04）和视觉空间功能（β画钟试验得分 = 0.52，95%置信区间0.11至0.94）显著更好。在调整混杂因素后，认知储备介导了身体活动与认知功能之间的关联，对整体认知功能的间接效应为（β蒙特利尔认知评估量表得分 = -0.29，95%置信区间 -0.56至 -0.09），对视觉空间功能的间接效应为（β画钟试验得分 = -0.14，95%置信区间 -0.28至 -0.05），中介比例分别为23.8%和26.7%。这些研究结果表明，高身体活动水平可能有效地增加社区居住老年人的认知储备，并维持或改善其认知功能。
