The association between midlife cardiorespiratory fitness levels and later-life dementia: a cohort study.
The association between midlife cardiorespiratory fitness levels and later-life dementia: a cohort study.
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DOI：
10.7326/0003-4819-158-3-201302050-00005
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发表时间：
2013-02-05
影响因子：
39.2
通讯作者：
Berry JD
中科院分区：
文献类型：
--
作者：
Defina LF;Willis BL;Radford NB;Gao A;Leonard D;Haskell WL;Weiner MF;Berry JD
阿尔茨海默病和其他类型痴呆（全因痴呆）的一级预防是一项重要的公共卫生目标。迄今为止的证据不足以建议改变生活方式来预防或延缓痴呆症的发作。 评估客观测量的中年心肺健康（“健康”）水平与高龄全因痴呆发展之间的关联。前瞻性、观察性队列研究。预防医学诊所。 19 458 名社区居住的非老年人接受了基线健康检查。健康水平，使用 1971 年至 2009 年间修改后的 Balke 跑步机协议进行评估，并使用 1999 年至 2009 年 Medicare A 部分和 B 部分索赔数据评估全因痴呆事件。在 125 700 人年的 Medicare 随访期间，发生了 1659 例全因痴呆事件（中位随访时间，25 年[四分位距，19 至 19]） 30 年]）。经过多变量调整后，健康水平最高五分位数的参与者比最低五分位数的参与者患全因痴呆的风险更低（风险比，0.64 [95% CI，0.54 至 0.77]）。较高的健康水平与既往有中风（风险比，0.74 [CI，0.53 至 1.04]）或无中风（风险比，0.74 [CI，0.61 至 0.90]）的全因痴呆风险较低相关。痴呆症诊断基于医疗保险索赔，参与者通常是非西班牙裔白人，健康且受过良好教育，并且可以获得预防性医疗保健。这项研究评估了健康水平，因此无法从结果中得出具体的运动处方，而且研究结果可能不存在因果关系。中年健康水平较高似乎与晚年患全因痴呆的风险较低相关。无论有无中风史，这种关联的程度和方向都相似，这表明生命早期较高的健康水平可能会降低晚年患痴呆症的风险，而与脑血管疾病无关。
Primary prevention of Alzheimer disease and other types of dementia (all-cause dementia) is an important public health goal. Evidence to date is insufficient to recommend any lifestyle change to prevent or delay the onset of dementia. To assess the association between objectively measured midlife cardiorespiratory fitness (“fitness”) levels and development of all-cause dementia in advanced age. Prospective, observational cohort study. Preventive medicine clinic. 19 458 community-dwelling, nonelderly adults who had a baseline fitness examination. Fitness levels, assessed using the modified Balke treadmill protocol between 1971 and 2009, and incident all-cause dementia using Medicare Parts A and B claims data from 1999 to 2009. 1659 cases of incident all-cause dementia occurred during 125 700 person-years of Medicare follow-up (median follow-up, 25 years [interquartile range, 19 to 30 years]). After multivariable adjustment, participants in the highest quintile of fitness level had lower hazard of all-cause dementia than those in the lowest quintile (hazard ratio, 0.64 [95% CI, 0.54 to 0.77]). Higher fitness levels were associated with lower hazard of all-cause dementia with previous stroke (hazard ratio, 0.74 [CI, 0.53 to 1.04]) or without previous stroke (hazard ratio, 0.74 [CI, 0.61 to 0.90]). Dementia diagnoses were based on Medicare claims, and participants generally were non-Hispanic white, healthy, and well-educated and had access to preventive health care. This study evaluated fitness levels, so a specific exercise prescription cannot be generated from results and the findings may not be causal. Higher midlife fitness levels seem to be associated with lower hazards of developing all-cause dementia later in life. The magnitude and direction of the association were similar with or without previous stroke, suggesting that higher fitness levels earlier in life may lower risk for dementia later in life, independent of cerebrovascular disease.
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影响因子：
9.9
作者：
Burns JM;Cronk BB;Anderson HS;Donnelly JE;Thomas GP;Harsha A;Brooks WM;Swerdlow RH
通讯作者：
Swerdlow RH
影响因子：
5.3
作者：
Adlard, PA;Perreau, VM;Cotman, CW
通讯作者：
Cotman, CW
影响因子：
4.8
作者：
POLLOCK, ML;BOHANNON, RL;LINNERUD, AC
通讯作者：
LINNERUD, AC
影响因子：
14
作者：
通讯作者：
--
影响因子：
--
作者：
Laurin, D;Verreault, R;Rockwood, K
通讯作者：
Rockwood, K