Leisure activities and the risk of dementia in the elderly
Leisure activities and the risk of dementia in the elderly
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DOI：
10.1056/nejmoa022252
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发表时间：
2003-06-19
影响因子：
158.5
通讯作者：
Buschke, H
中科院分区：
文献类型：
--
作者：
Verghese, J;Lipton, RB;Buschke, H
背景：参与休闲活动与痴呆症的风险降低有关。目前还不清楚是否增加参与休闲活动降低痴呆症的风险或参与休闲活动下降在临床前阶段dementia. METHODS：我们研究了休闲活动和痴呆症的风险之间的关系，在一个前瞻性队列的469名受试者年龄超过75岁，居住在社区，并没有痴呆症的基线。我们检查了参与休闲活动的频率，并得出认知活动和身体活动量表，其中的测量单位是每周的活动天数。考克斯比例风险分析被用来评估痴呆症的风险，根据基线水平的参与休闲活动，调整年龄，性别，教育水平，存在或不存在的慢性医学疾病，和基线cognitive status.Results：在一个中位数为5.1年的随访期间，痴呆症的发展在124名受试者（阿尔茨海默氏病61例，血管性痴呆30例，混合性痴呆25例，其他类型的痴呆8例）。在休闲活动中，阅读、玩棋盘游戏、演奏乐器和跳舞与痴呆症风险降低有关。认知活动评分增加一分与痴呆风险降低显著相关（风险比，0.93 [95%置信区间，0.90~0.97]），但体力活动评分增加一分与此无关（风险比，1.00）。在排除基线时可能患有临床前痴呆的受试者后，与认知活动评分的相关性持续存在。阿尔茨海默病和血管性痴呆的结果相似。在线性混合模型中，增加参与认知活动在基线是与减少率的下降memory.CONCLUSIONS：参与休闲活动与痴呆症的风险降低，即使调整后的基线认知状态和排除后的主题可能的临床前痴呆症。需要对照试验来评估认知休闲活动对痴呆症风险的保护作用。
BACKGROUND:Participation in leisure activities has been associated with a lower risk of dementia. It is unclear whether increased participation in leisure activities lowers the risk of dementia or participation in leisure activities declines during the preclinical phase of dementia.METHODS:We examined the relation between leisure activities and the risk of dementia in a prospective cohort of 469 subjects older than 75 years of age who resided in the community and did not have dementia at base line. We examined the frequency of participation in leisure activities at enrollment and derived cognitive-activity and physical-activity scales in which the units of measure were activity-days per week. Cox proportional-hazards analysis was used to evaluate the risk of dementia according to the base-line level of participation in leisure activities, with adjustment for age, sex, educational level, presence or absence of chronic medical illnesses, and base-line cognitive status.RESULTS:Over a median follow-up period of 5.1 years, dementia developed in 124 subjects (Alzheimer's disease in 61 subjects, vascular dementia in 30, mixed dementia in 25, and other types of dementia in 8). Among leisure activities, reading, playing board games, playing musical instruments, and dancing were associated with a reduced risk of dementia. A one-point increment in the cognitive-activity score was significantly associated with a reduced risk of dementia (hazard ratio, 0.93 [95 percent confidence interval, 0.90 to 0.97]), but a one-point increment in the physical-activity score was not (hazard ratio, 1.00). The association with the cognitive-activity score persisted after the exclusion of the subjects with possible preclinical dementia at base line. Results were similar for Alzheimer's disease and vascular dementia. In linear mixed models, increased participation in cognitive activities at base line was associated with reduced rates of decline in memory.CONCLUSIONS:Participation in leisure activities is associated with a reduced risk of dementia, even after adjustment for base-line cognitive status and after the exclusion of subjects with possible preclinical dementia. Controlled trials are needed to assess the protective effect of cognitive leisure activities on the risk of dementia.