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[中国老年人群生活方式与载脂蛋白E基因与认知衰弱风险的关联]

[Association of lifestyle and apolipoprotein E gene with risk for cognitive frailty in elderly population in China].

作者信息

Zhong W F, Wang X M, Song W Q, Li C, Chen H, Chen Z T, Lyu Y B, Li Z H, Shi X M, Mao C

机构信息

Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou 510515, China.

China CDC Key Laboratory of Environment and Population Health/National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Jan 10;45(1):41-47. doi: 10.3760/cma.j.cn112338-20231027-00254.

Abstract

To investigate the impact of lifestyle, apolipoprotein E (ApoE) gene, and their interaction on the risk for cognitive frailty in the elderly population in China. The study participants were from the Chinese Longitudinal Healthy Longevity Survey. The information about their lifestyles were collected by questionnaire survey, and a weighted lifestyle score was constructed based on coefficients associated with specific lifestyles to assess the combined lifestyle. ApoE genotypes were assessed by rs429358 and rs7412 single nucleotide polymorphisms. Cognitive frailty was assessed based on cognitive function and physical frailty. Cox proportional hazards regression model was used to analyze the association of lifestyle and ApoE gene with the risk for cognitive frailty and evaluate the multiplicative and additive interactions between lifestyle and ApoE gene. A total of 5 676 elderly persons, with median age [ (, )] of 76 (68, 85) years, were included, in whom 615 had cognitive frailty. The analysis by Cox proportional hazards regression model indicated that moderate and high levels of dietary diversity could reduce the risk for cognitive frailty by 18% [hazard ratio ()=0.82, 95%: 0.68-1.00] and 28% (=0.72, 95%: 0.57-0.91), respectively; moderate and high levels of physical activity could reduce the risk by 31% (=0.69, 95%: 0.56-0.85) and 23% (=0.77, 95%: 0.64-0.93), respectively. Healthy lifestyle was associated with a 40% reduced risk for cognitive frailty (=0.60, 95%: 0.46-0.78). ApoE ε4 allele was associated with a 26% increased risk for cognitive frailty (1.26, 95%: 1.02-1.56). No multiplicative or additive interactions were found between lifestyle and ApoE gene. Dietary diversity and regular physical activity have protective effects against cognitive frailty in elderly population. Healthy lifestyle can reduce the risk for cognitive frailty in elderly population regardless of ApoE ε4 allele carriage status.

摘要

探讨生活方式、载脂蛋白E(ApoE)基因及其相互作用对中国老年人群认知衰弱风险的影响。研究参与者来自中国健康与养老追踪调查。通过问卷调查收集他们的生活方式信息,并根据与特定生活方式相关的系数构建加权生活方式评分,以评估综合生活方式。通过rs429358和rs7412单核苷酸多态性评估ApoE基因型。基于认知功能和身体衰弱评估认知衰弱。采用Cox比例风险回归模型分析生活方式和ApoE基因与认知衰弱风险的关联,并评估生活方式与ApoE基因之间的相乘和相加相互作用。共纳入5676名老年人,年龄中位数[(,)]为76(68,85)岁,其中615人有认知衰弱。Cox比例风险回归模型分析表明,中等和高水平的饮食多样性可分别将认知衰弱风险降低18%[风险比()=0.82,95%可信区间:0.68 - 1.00]和28%(=0.72,95%可信区间:0.57 - 0.91);中等和高水平的身体活动可分别将风险降低31%(=0.69,95%可信区间:0.56 - 0.85)和23%(=0.77,95%可信区间:0.64 - 0.93)。健康的生活方式与认知衰弱风险降低40%相关(=0.60,95%可信区间:0.46 - 0.78)。ApoEε4等位基因与认知衰弱风险增加26%相关(1.26, 95%可信区间:1.02 - 1.56)。未发现生活方式与ApoE基因之间存在相乘或相加相互作用。饮食多样性和规律的身体活动对老年人群认知衰弱具有保护作用。无论是否携带ApoEε4等位基因,健康的生活方式均可降低老年人群认知衰弱的风险。

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