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中国老年人健康生活方式的改变与认知障碍风险的后续变化:一项基于全国社区的队列研究。

Change in Healthy Lifestyle and Subsequent Risk of Cognitive Impairment Among Chinese Older Adults: A National Community-Based Cohort Study.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Jilin, Changchun, China.

出版信息

J Gerontol A Biol Sci Med Sci. 2024 Aug 1;79(8). doi: 10.1093/gerona/glae148.

Abstract

BACKGROUND

The association between change in lifestyle and cognitive impairment remains uncertain.

OBJECTIVES

To investigate the association of change in lifestyle with cognitive impairment.

METHODS

In this study, 4 938 participants aged 65 or older were involved from the Chinese Longitudinal Healthy Longevity Survey for years 2008-2018. A weighted healthy lifestyle score was derived from 4 lifestyle factors (smoking, alcohol consumption, physical activity, and diet). Multivariable Cox proportional hazards regression models were applied to investigate the associations between 3-year changes in healthy lifestyle (2008-2011) and cognitive impairment (2011-2018).

RESULTS

Researchers documented 833 new-onset of cognitive impairments more than 20 097 person-years of follow up. Compared with those in the persistently unhealthy group, those in the improved and persistently healthy groups had a lower risk of cognitive impairment, with the multivariate-adjusted hazard ratios (HRs) of 0.67 (95% confidence interval (CI): 0.55, 0.83) and 0.53 (95% CI: 0.40, 0.71), respectively. Furthermore, a significant interaction was observed between change in lifestyle and sex (p-interaction = .032); the HRs were 0.48 (95% CI, 0.34, 0.69) for the improved group and 0.41 (95% CI: 0.26, 0.64) for persistently healthy group among male vs 0.81 (95% CI, 0.63, 1.04) and 0.64 (95% CI, 0.44, 0.92) among female, respectively.

CONCLUSIONS

This study suggests that improving or maintaining a healthy lifestyle can significantly mitigate the risk of cognitive impairment in Chinese older adults. Additionally, researcher's findings emphasize the significance of maintaining a healthy lifestyle and highlights the potential positive impact of improving previous unhealthy habits, especially for older women.

摘要

背景

生活方式改变与认知障碍之间的关联仍不确定。

目的

探究生活方式改变与认知障碍的关联。

方法

本研究纳入了中国老年人纵向健康长寿研究中 2008-2018 年的 4938 名 65 岁及以上的参与者。采用 4 项生活方式因素(吸烟、饮酒、身体活动和饮食)计算加权健康生活方式评分。采用多变量 Cox 比例风险回归模型来探究 3 年健康生活方式变化(2008-2011 年)与认知障碍(2011-2018 年)之间的关联。

结果

在 20097 人年的随访中,研究者记录到 833 例新发认知障碍。与持续处于不健康状态的人群相比,改善组和持续健康组发生认知障碍的风险较低,调整后的多变量风险比(HR)分别为 0.67(95%置信区间(CI):0.55,0.83)和 0.53(95%CI:0.40,0.71)。此外,生活方式变化与性别之间存在显著交互作用(p 交互值=0.032);与持续健康组相比,男性中改善组的 HR 为 0.48(95%CI,0.34,0.69),持续健康组为 0.41(95%CI:0.26,0.64);女性中改善组为 0.81(95%CI,0.63,1.04),持续健康组为 0.64(95%CI:0.44,0.92)。

结论

本研究表明,改善或维持健康的生活方式可显著降低中国老年人发生认知障碍的风险。此外,研究结果强调了保持健康生活方式的重要性,并提示改善先前不健康的生活习惯可能带来积极影响,尤其是对老年女性。

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