Trajectories of occupational physical activity and risk of later-life mild cognitive impairment and dementia: the HUNT4 70+ study.
Trajectories of occupational physical activity and risk of later-life mild cognitive impairment and dementia: the HUNT4 70+ study.
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DOI：
10.1016/j.lanepe.2023.100721
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发表时间：
2023-11
影响因子：
20.9
通讯作者：
Skirbekka, Vegard
中科院分区：
文献类型：
--
作者：
Zotcheva, Ekaterina;Bratsberg, Bernt;Strand, Bjorn Heine;Jugessur, Astanand;Engdahl, Bo Lars;Bowen, Catherine;Selbaek, Geir;Kohler, Hans-Peter;Harris, Jennifer R.;Weiss, Jordan;Tom, Sarah E.;Krokstad, Steinar;Mekonnen, Teferi;Edwin, Trine Holt;Stern, Yaakov;Haberg, Asta Kristine;Skirbekka, Vegard
高水平的职业体力活动（PA）与痴呆症的风险增加有关。我们评估了33-65岁职业PA轨迹与70岁以上痴呆和轻度认知障碍（MCI）风险的相关性。我们纳入了来自HUNT 4 70+研究的7005名参与者（49.8%为女性，3488/7005）。基于1960年至2014年的国家登记数据，使用基于组的轨迹建模来确定职业PA的四个轨迹：稳定的低（30.9%，2162/7005）、先升后降（8.9%，625/7005）、稳定中间（25.1%，1755/7005）、稳定高（35.2%，2463/7005）。痴呆和MCI在2017-2019年进行了临床评估。我们进行了调整多项式回归，以估计痴呆和MCI的相对危险比（RRR）和95%置信区间（CI）。902名参与者被诊断患有痴呆症，2407名被诊断患有MCI。痴呆和MCI的绝对未校正风险为8.8%（95% CI：7.6-10.0）和27.4%（25.5-29.3），对于具有稳定低PA轨迹的患者，8.2%（6.0-10.4）和33.3%（29.6-37.0）PA先增后减;稳定的中间型和稳定的高PA轨迹型分别为16.0%（14.3-17.7）和35%（32.8-37.2），15.4%（14.0-16.8）和40.2%（38.3-42.1）。在调整后的模型中，与稳定的低轨迹相比，具有稳定的高轨迹的参与者患痴呆症（RRR 1.34，1.04-1.73）和MCI（1.80，1.54-2.11）的风险较高，而具有稳定的中间轨迹的参与者患MCI（1.36，1.15-1.61）的风险较高。虽然没有统计学显著性，但与稳定的低PA组相比，职业PA增加然后减少的参与者患痴呆症的风险降低24%，患MCI的风险增加18%。持续从事中等或高职业性PA的职业与认知障碍的风险增加有关，这表明为从事体力要求较高的职业的个人制定策略以预防认知障碍的重要性。这项工作得到了（R 01 AG 069109 -01）和（296297、262700、288083）的支持。
High levels of occupational physical activity (PA) have been linked to an increased risk of dementia. We assessed the association of trajectories of occupational PA at ages 33–65 with risk of dementia and mild cognitive impairment (MCI) at ages 70+. We included 7005 participants (49.8% were women, 3488/7005) from the HUNT4 70+ Study. Group-based trajectory modelling was used to identify four trajectories of occupational PA based on national registry data from 1960 to 2014: stable low (30.9%, 2162/7005), increasing then decreasing (8.9%, 625/7005), stable intermediate (25.1%, 1755/7005), and stable high (35.2%, 2463/7005). Dementia and MCI were clinically assessed in 2017–2019. We performed adjusted multinomial regression to estimate relative risk ratios (RRR) with 95% confidence intervals (CI) for dementia and MCI. 902 participants were diagnosed with dementia and 2407 were diagnosed with MCI. Absolute unadjusted risks for dementia and MCI were 8.8% (95% CI: 7.6–10.0) and 27.4% (25.5–29.3), respectively, for those with a stable low PA trajectory, 8.2% (6.0–10.4) and 33.3% (29.6–37.0) for those with increasing, then decreasing PA; while they were 16.0% (14.3–17.7) and 35% (32.8–37.2) for those with stable intermediate, and 15.4% (14.0–16.8) and 40.2% (38.3–42.1) for those with stable high PA trajectories. In the adjusted model, participants with a stable high trajectory had a higher risk of dementia (RRR 1.34, 1.04–1.73) and MCI (1.80, 1.54–2.11), whereas participants with a stable intermediate trajectory had a higher risk of MCI (1.36, 1.15–1.61) compared to the stable low trajectory. While not statistically significant, participants with increasing then decreasing occupational PA had a 24% lower risk of dementia and 18% higher risk of MCI than the stable low PA group. Consistently working in an occupation with intermediate or high occupational PA was linked to an increased risk of cognitive impairment, indicating the importance of developing strategies for individuals in physically demanding occupations to prevent cognitive impairment. This work was supported by the (R01AG069109-01) and the (296297, 262700, 288083).
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