Dong Qiwei, Li Yuanjing, Song Yiming, Zhang Yu, Han Xiaodong, Ren Yifei, Wang Jiafeng, Han Xiaojuan, Du Yifeng
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Department of Neurobiology, Care Sciences and Society, Aging Research Center and Centerfor Alzheimer Research, Karolinska Institute-Stockholm University, Stockholm, Sweden.
J Alzheimers Dis Rep. 2024 Oct 1;8(1):1329-1338. doi: 10.3233/ADR-240064. eCollection 2024.
Cognitive reserve (CR) may be beneficial to the physical function of the elderly.
We aimed to examine the association of CR proxies and composite CR capacity with physical function in older adults while considering age and sex.
This population-based cross-sectional study included 4,714 participants living in rural China (age≥60 years) who were dementia-free. Structural equation modeling was used to generate a composite CR score by integrating early-life education, midlife occupational complexity, and late-life mental activity and social support. The Short Physical Performance Battery (SPPB) measured physical function. Data were analyzed using linear regression models.
Greater educational attainment and mental activity were associated with higher composite SPPB scores and those of its three subtests ( < 0.05). Skilled occupations were associated with higher SPPB, chair stand, and walking speed scores, while greater social support was associated with higher scores for SPPB and chair stand ( < 0.05). Each 1-point increase in composite CR score (range: -0.77 to 1.03) was linearly associated with a multivariable-adjusted β-coefficient of 0.74 (95% confidence interval (CI): 0.58-0.89) for total SPPB score, 0.16 (0.10-0.22) for balance test, 0.40 (0.32-0.48) for chair stand, and 0.17 (0.12-0.23) for walking speed. The association between higher composite CR and total SPPB scores was more prominent in those≥75 years than those aged 60-74 years ( < 0.01). There was no statistical interaction of composite CR score and sex in physical function.
High CR is associated with better physical function, especially among older adults (≥75 years).
认知储备（CR）可能对老年人的身体功能有益。
我们旨在研究在考虑年龄和性别的情况下，CR指标及综合CR能力与老年人身体功能之间的关联。
这项基于人群的横断面研究纳入了4714名居住在中国农村地区（年龄≥60岁）且无痴呆症的参与者。采用结构方程模型，通过整合早年教育、中年职业复杂性以及晚年精神活动和社会支持来生成综合CR评分。使用简短体能状况量表（SPPB）测量身体功能。采用线性回归模型对数据进行分析。
受教育程度越高和精神活动越丰富，与综合SPPB评分及其三个子测试的得分越高相关（<0.05）。技能型职业与较高的SPPB、椅子站立和步行速度得分相关，而更多的社会支持与SPPB和椅子站立得分较高相关（<0.05）。综合CR评分每增加1分（范围：-0.77至1.03），与总SPPB评分的多变量调整β系数为0.74（95%置信区间（CI）：0.58 - 0.89），平衡测试为0.16（0.10 - 0.22），椅子站立为0.40（0.32 - 0.48），步行速度为0.17（0.12 - 0.23）。较高的综合CR与总SPPB评分之间的关联在75岁及以上人群中比60 - 74岁人群更为显著（<0.01）。在身体功能方面，综合CR评分与性别之间无统计学交互作用。
高CR与更好的身体功能相关，尤其是在老年人（≥75岁）中。
