A prospective study of physical activity and cognitive decline in elderly women - Women who walk
A prospective study of physical activity and cognitive decline in elderly women - Women who walk
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DOI：
10.1001/archinte.161.14.1703
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发表时间：
2001-07-23
影响因子：
--
通讯作者：
Covinsky, K
中科院分区：
文献类型：
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作者：
Yaffe, K;Barnes, D;Covinsky, K
背景：一些研究表明，体力活动与老年人的认知功能呈正相关。由于大多数研究的横断面设计以及经常缺乏对潜在混杂变量的调整，有关这种关联的证据受到限制。我们在一项对老年妇女的前瞻性研究中确定了体育活动是否与认知能力下降有关。方法：我们研究了4个临床中心招募的5925名主要居住在社区的白人妇女（年龄大于或等于65岁），她们没有基线认知障碍或身体限制。我们在基线和6至8年后使用改进的迷你精神状态检查来测量认知表现。通过自我报告每周步行的街区（1个街区约160米）和每周在娱乐、步行街区和爬楼梯上消耗的总千卡（能量）来测量身体活动。认知能力下降定义为在重复修正的迷你精神状态检查中出现3分或以上的下降。结果：在6至8年的随访中，基线体力活动水平较高的女性认知能力下降的可能性较小：在每周步行最多、第三、第二和最低四分位数的女性中，认知能力下降的比例分别为17%、18%、22%和24%（趋势P < 0.001）。每周消耗的总千卡数的四分之一得到了几乎相同的结果。在调整了年龄、教育水平、合共疾病、吸烟状况、雌激素使用和功能限制等因素后，最高四分位数的女性仍比最低四分位数的女性发生认知能力下降的可能性更小（对于步行街区：优势比为0.66[95%置信区间，0.54-0.82]；对于总千卡：优势比为0.74[95%置信区间，0.60-0.90]）。结论：基线体力活动水平较高的女性发生认知能力下降的可能性较小。这种关联不能用基线功能或健康状况的差异来解释。这一发现支持了体育活动可以防止老年社区妇女认知能力下降的假设。
Background: Several studies have suggested that physical activity is positively associated with cognitive function in elderly persons. Evidence about this association has been limited by the cross-sectional design of most studies and by the frequent lack of adjustment for potential confounding variables. We determined whether physical activity is associated with cognitive decline in a prospective study of older women.Methods: We studied 5925 predominantly white community-dwelling women (aged greater than or equal to 65 years) who were recruited at 4 clinical centers and were without baseline cognitive impairment or physical limitations. We measured cognitive performance using a modified Mini-Mental State Examination at baseline and 6 to 8 years later. Physical activity was measured by self-reported blocks (1 block approximate to 160 m) walked per week and by total kilocalories (energy) expended per week in recreation, blocks walked, and stairs climbed. Cognitive decline was defined as a 3-point decline or greater on repeated modified Mini-Mental State Examination.Results: Women with a greater physical activity level at baseline were less likely to experience cognitive de dine during the 6 to 8 years of follow-up: cognitive decline occurred in 17%, 18%, 22%, and 24% of those in the highest, third, second, and lowest quartile of blocks walked per week (P < .001 for trend). Almost identical results were obtained by quartile of total kilocalories expended per week. After adjustment for age, educational level, comorbid conditions, smoking status, estrogen use, and functional limitation, women in the highest quartile remained less likely than women in the lowest quartile to develop cognitive decline (for blocks walked: odds ratio, 0.66 [95% confidence interval, 0.54-0.82]; for total kilocalories: odds ratio, 0.74 [95% confidence interval, 0.60-0.90]).Conclusions: Women with higher levels of baseline physical activity were less likely to develop cognitive decline. This association was not explained by differences in baseline function or health status. This finding supports the hypothesis that physical activity prevents cognitive decline in older community-dwelling women.