Community-Level Sports Group Participation and the Risk of Cognitive Impairment
Community-Level Sports Group Participation and the Risk of Cognitive Impairment
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DOI：
10.1249/mss.0000000000002050
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发表时间：
2019-11-01
影响因子：
4.1
通讯作者：
Kondo, Katsunori
中科院分区：
文献类型：
--
作者：
Tsuji, Taishi;Kanamori, Satoru;Kondo, Katsunori
社区层面的群体参与是社会资本的一个结构性方面，可能对个人健康产生背景影响。我们调查了社区体育团体参与率对老年人认知障碍风险的影响。方法我们分析了来自日本老年学评估研究的前瞻性队列数据，该研究是一项全国性调查，共有来自346个社区的40，308名功能独立的老年人。认知功能障碍采用日本厚生劳动省提出的国家标准化痴呆量表进行评估。每月参加体育活动1天或更频繁被定义为“参与”。“我们应用了两级多水平生存分析来计算风险比（HR）和95%置信区间（CI）。结果在6年的随访期内，认知功能障碍的累积发生率为9.8%。参加体育团体活动的比例平均为25.2%（范围：0.0%-56.5%）。社区体育团体参与率较高与认知障碍风险较低相关（HR，0.92; 95%CI，0.86-0.99，按参与比例10个百分点估算）调整个人水平运动组参与、性别、年龄、疾病、肥胖、社会隔离、饮酒、吸烟、教育、收入、抑郁、每日步行时间后，人口密度和日照时数我们发现个人和社区体育团体参与之间存在跨层次的相互作用（HR，0.87; 95%CI，0.76-0.99）。结论：我们发现社区体育团体参与对老年人认知障碍的发展具有背景预防作用。此外，这种好处可能有利于体育团体的参与者。因此，在社区环境中促进体育团体可能是有效的预防痴呆症的人口为基础的战略。
Purpose Community-level group participation is a structural aspect of social capital that may have a contextual influence on individual health. We investigated the contextual effect of community-level prevalence of sports group participation on the risk of cognitive impairment among older individuals. Methods We analyzed prospective cohort data from the Japan Gerontological Evaluation Study, a nationwide survey of 40,308 functionally independent older individuals from 346 communities. Cognitive impairment was assessed by the nationally standardized dementia scale proposed by the Ministry of Health, Labour and Welfare of Japan. Participation in a sports group 1 d per month or more frequently was defined as "participation." We applied a two-level multilevel survival analysis to calculate hazard ratios (HR) and 95% confidence intervals (CI). Results The cumulative incidence of cognitive impairment during the 6-yr follow-up period was 9.8%. The mean proportion of sports group participation was 25.2% (range, 0.0%-56.5%). Higher prevalence of community-level sports group participation was associated with a lower risk of cognitive impairment (HR, 0.92; 95% CI, 0.86-0.99, estimated by 10 percentage points of participation proportion) after adjusting for individual-level sports group participation, sex, age, disease, obesity, social isolation, alcohol, smoking, education, income, depression, daily walking time, population density, and sunlight hours. We found cross-level interaction between individual- and community-level sports group participation (HR, 0.87; 95% CI, 0.76-0.99). Conclusions We found a contextual preventive effect of community-level sports group participation on developing cognitive impairment among older individuals. Furthermore, the benefit may favor sports group participants. Therefore, promoting sports groups in a community setting may be effective as a population-based strategy for the prevention of dementia.