Hu Huixiu, Zhao Yajie, Hao Yuqing, Luo Huanhuan, Xie Lanying, Sun Chao
Department of Nursing, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, No.1 Dahua, Dongcheng District, Beijing, 100730, China, 01085138594.
Department of Clinical Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
JMIR Public Health Surveill. 2025 Aug 12;11:e73398. doi: 10.2196/73398.
BACKGROUND: Many lifestyle behaviors-including smoking, alcohol consumption, and engagement in physical activity and social activity-have been identified as potential determinants of the risk of cognitive impairment. Understanding how those lifestyle behavior patterns in older adults affect cognitive function is crucial for developing targeted interventions. OBJECTIVE: This study examined the lifestyle behavior patterns of Chinese community-dwelling older adults and their associations with cognitive impairment. METHODS: A cross-sectional study was conducted with 2060 community-dwelling older adults in Beijing, China. Latent class analysis identified distinct lifestyle behavior patterns based on unhealthy lifestyle behaviors (smoking and alcohol consumption) and healthy behaviors (physical activity and social activity). Cognitive function was evaluated using the Mini-Mental State Examination. Multiple logistic regression was conducted to examine the associations between lifestyle behavior patterns and cognitive impairment. RESULTS: Three distinct lifestyle behavior patterns emerged: (1) high control-high engagement (685/2060, 33.3%), (2) high control-low engagement (1210/2060, 58.7%), and (3) low control-low engagement (165/2060, 8.0%). The high control-high engagement group, characterized by non-smoking, low-to-moderate alcohol consumption, and frequent engagement in physical and social activities, exhibited the lowest risk of cognitive impairment. In contrast, participants in the high control-low engagement group (OR 1.852, 95% CI 1.314-2.655) and low control-low engagement group (OR 2.905, 95% CI 1.670-5.001) exhibited significantly higher risks. Subgroup analyses revealed that males and hypertensive individuals within the high control-low engagement group were at an even greater risk. CONCLUSIONS: Our findings revealed that both avoiding harmful behaviors and actively engaging in health-promoting activities are important for cognitive health in older adults. Based on the results, we propose adopting a dual-pathway intervention model in policy making, simultaneously optimizing risk behaviors management and healthy behaviors promotion mechanisms.
背景：许多生活方式行为，包括吸烟、饮酒、参与体育活动和社交活动，已被确定为认知障碍风险的潜在决定因素。了解老年人的这些生活方式行为模式如何影响认知功能对于制定有针对性的干预措施至关重要。 目的：本研究调查了中国社区居住老年人的生活方式行为模式及其与认知障碍的关联。 方法：对中国北京2060名社区居住老年人进行了一项横断面研究。潜在类别分析根据不健康的生活方式行为（吸烟和饮酒）和健康行为（体育活动和社交活动）确定了不同的生活方式行为模式。使用简易精神状态检查表评估认知功能。进行多因素逻辑回归以检验生活方式行为模式与认知障碍之间的关联。 结果：出现了三种不同的生活方式行为模式：（1）高控制-高参与（685/2060，33.3%），（2）高控制-低参与（1210/2060，58.7%），以及（3）低控制-低参与（165/2060，8.0%）。高控制-高参与组的特征是不吸烟、低至中度饮酒以及频繁参与体育和社交活动，其认知障碍风险最低。相比之下，高控制-低参与组（比值比1.852，95%置信区间1.314-2.655）和低控制-低参与组（比值比2.905，95%置信区间1.670-5.001）的参与者表现出明显更高的风险。亚组分析显示，高控制-低参与组中的男性和高血压个体风险更高。 结论：我们的研究结果表明，避免有害行为和积极参与促进健康的活动对老年人的认知健康都很重要。基于这些结果，我们建议在政策制定中采用双途径干预模式，同时优化风险行为管理和健康行为促进机制。
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