Cognitive activity and incident AD in a population-based sample of older persons
Cognitive activity and incident AD in a population-based sample of older persons
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DOI：
10.1212/01.wnl.0000036905.59156.a1
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发表时间：
2002-12-24
期刊：
影响因子：
9.9
通讯作者：
Evans, DA
中科院分区：
文献类型：
--
作者：
Wilson, RS;Bennett, DA;Evans, DA
背景：参与认知刺激活动被认为与阿尔茨海默病的风险有关，但对这种联系的了解有限。方法：对芝加哥的一个混血社区进行人口普查，邀请65岁及以上的老年人参加访谈，7826名符合条件的人中有6158人参加了访谈(79%)。作为采访的一部分，受访者对七项认知活动(例如，看报纸)和九项体育活动(例如，散步锻炼)的当前参与频率进行了评级，从这些活动中得出了认知和身体活动频率的综合衡量标准。四年后，1249名被判定为无阿尔茨海默病的人被抽样进行详细的疾病临床评估，其中842人(符合条件的人中有74%)参与其中。结果：认知活动的综合测量范围为1.28~4.71(平均值为3.30；SD为0.59)，得分越高，表明活动越频繁。共有139人在临床评估上符合美国国家神经与沟通障碍和中风-阿尔茨海默病及相关疾病协会的AD标准。在调整了年龄、教育程度、性别、种族和是否拥有apoE epsilon4等位基因的Logistic回归模型中，认知活动分数每增加1分，发生AD的风险降低%(OR 0.36；95%CI 0.20至0.65)。相比之下，每周体力活动时间(平均3.5小时；标准差5.1)与疾病风险无关(OR 1.04；95%CI 0.98至1.10)。教育与阿尔茨海默病的风险相关，职业也存在类似的趋势，但当认知活动添加到模型中时，这些影响大大降低。结论：参与认知刺激活动的频率似乎与阿尔茨海默病的风险相关，并可能部分解释教育和职业成就与疾病风险的关联。
Background: Participation in cognitively stimulating activities is hypothesized to be associated with risk of AD, but knowledge about this association is limited. Methods: A biracial community in Chicago was censused, persons aged 65 years and older were asked to participate in an interview, and 6,158 of 7,826 (79%) eligible persons did so. As part of the interview, persons rated current frequency of participation in seven cognitive activities (e.g., reading a newspaper) and nine physical activities (e.g., walking for exercise) from which composite measures of cognitive and physical activity frequency were derived. Four years later, 1,249 of those judged free of AD were sampled for a detailed clinical evaluation of incident disease and 842 (74% of those eligible) participated. Results: The composite measure of cognitive activity ranged from 1.28 to 4.71 (mean 3.30; SD 0.59), with higher scores indicating more frequent activity. A total of 139 persons met National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria for AD on clinical evaluation. In a logistic regression model adjusted for age, education, sex, race, and possession of the APOE epsilon4 allele, a one-point increase in cognitive activity score was associated with a 64% reduction in risk of incident AD (OR 0.36; 95% Cl 0.20 to 0.65). By contrast, weekly hours of physical activity (mean 3.5; SD 5.1) was not related to disease risk (OR 1.04; 95% CI 0.98 to 1.10). Education was associated with risk of AD and a similar trend was present for occupation, but these effects were substantially reduced when cognitive activity was added to the model. Conclusion: Frequency of participation in cognitively stimulating activities appears to be associated with risk of AD and may partially explain the association of educational and occupational attainment with disease risk.