Lifestyle and Cognitive Decline in Community-Dwelling Stroke Survivors.
Lifestyle and Cognitive Decline in Community-Dwelling Stroke Survivors.
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DOI：
10.3233/jad-220305
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发表时间：
2022
影响因子：
4
通讯作者：
Rajan, Kumar B.
中科院分区：
文献类型：
--
作者：
Dhana, Klodian;Aggarwal, Neelum T.;Beck, Todd;Holland, Thomas M.;Dhana, Anisa;Cherian, Laurel J.;Desai, Pankaja;Evans, Denis A.;Rajan, Kumar B.
中风患者患认知障碍和阿尔茨海默氏症的风险更高。量化卒中前、卒中后生活方式的作用，以及在社区居住的卒中幸存者中，卒中前后生活方式的变化与认知能力下降的关系。利用芝加哥健康和老龄化项目的数据，这是一项基于人群的队列研究，我们研究了1078名中风患者(662例，416例)，他们在研究期间接受了认知测试。健康生活方式的得分是通过对四种行为的评分来定义的，这四种行为分别是不吸烟、锻炼、积极认知和高质量饮食。全球认知得分是从4个标准化测试的综合组合中得出的。发生中风的平均年龄为78.2岁，其中60.1%是女性。中风前健康的生活方式与中风后认知功能减退的速度较慢有关。卒中前有3-4个健康生活方式因素的参与者在卒中后认知功能下降比0-1健康生活方式因素的参与者慢0.046个单位/年(95%CI 0.010，0.083)，或47.7%慢。中风流行后的生活方式得分与认知能力下降无关。卒中前后生活方式行为的改变与卒中后认知功能下降有关。与生活方式得分没有变化的参与者相比，中风后生活质量恶化的人的认知下降速度更快，为0.051个单位/年(β−0.051，95%CI−0.090，−0.012)。中风前健康的生活方式与中风幸存者的认知下降速度较慢有关，这突显了一级预防的重要性。中风后，随着老年人年龄的增长，生活方式行为的变化可能会影响他们的认知能力。
Patients with stroke are at a higher risk of cognitive impairment and Alzheimer’s dementia. To quantify the role of lifestyle pre-stroke, post-stroke, and changes in lifestyle before and after stroke with cognitive decline in community-dwelling stroke survivors. Utilizing data from the Chicago Health and Aging Project, a population-based cohort study, we studied 1,078 individuals with stroke (662 incident and 416 prevalent) who underwent cognitive testing during the study period. A healthy lifestyle score was defined by scoring four behaviors, non-smoking, exercising, being cognitively active, and having a high-quality diet. The global cognitive score was derived from a comprehensive battery of 4 standardized tests. The mean age at incident stroke was 78.2 years, and 60.1% were women. A healthy lifestyle pre-incident stroke was associated with a slower rate of cognitive decline after stroke. Participants with 3-4 healthy lifestyle factors pre-incident stroke had a slower cognitive decline after stroke by 0.046 units/year (95%CI 0.010, 0.083), or 47.7% slower, than participants with 0-1 healthy lifestyle factor. Lifestyle score post-prevalent stroke was not associated with cognitive decline. Changes in lifestyle behaviors from pre- to post-incident stroke were related to cognitive decline after stroke. Individuals who deteriorated their lifestyle quality after stroke had a faster cognitive decline by 0.051 units/year (β −0.051, 95%CI −0.090, −0.012) than participants with no change in lifestyle score. A healthy lifestyle pre-stroke was associated with a slower rate of cognitive decline in stroke survivors, highlighting the importance of primary prevention. After the stroke, changes in lifestyle behaviors may influence the cognitive abilities of older adults as they age.