Aggio et al. Respond to "Lessons for Research on Cognitive Aging".
Aggio et al. Respond to "Lessons for Research on Cognitive Aging".
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DOI：
10.1093/aje/kww030
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发表时间：
2016-06-15
影响因子：
5
通讯作者：
Hamer M
中科院分区：
文献类型：
--
作者：
Aggio D;Smith L;Fisher A;Hamer M
我们感谢 Belsky 博士 (1) 对我们的研究 (2) 的兴趣，我们在该研究中调查了年轻人身体活动与认知功能之间的关联。他提出了关于身体活动作为预防认知能力下降的公共卫生策略的几个重要问题。 “神经选择”问题是观察性研究中潜在的偏差来源，即认知功能较好的个体更有可能从事体育活动等健康行为，而避免吸烟等不健康行为。另一种假设是“神经保护”，其中健康行为可能会促进认知发展。我们同意，预先存在的特征造成的混淆是任何流行病学工作中的一个普遍问题。事实上，我们的加速度测量样本中的孩子通常来自较富裕的家庭，并且比分析中排除的孩子的父母受教育程度更高。神经选择还可以解释观察到的身体活动和认知功能之间的关联。纵向研究提供了一个机会来调查基线认知功能是否与以后生活中的积极健康行为相关。例如，认知功能较好的儿童在成年后表现出较高的健康水平 (3)。一种潜在的机制可能是，与认知功能较低的个体相比，认知功能较高的个体能够更好地解释和响应健康建议 (4)。神经选择假说的基础是，认知功能较高的个体选择过更健康的生活。然而，在我们的研究 (2) 中，身体活动是在 7 岁时测量的，这意味着如果神经选择论点成立，那么认知功能较高的儿童在这么小的年龄就已经选择了活动。该年龄段儿童对健康行为的了解有限（5），这表明无论认知能力如何，幼儿可能无法正确识别健康行为。此外，在幼儿期，由于自主性较低，健康行为的自我选择可能会受到限制。
We thank Dr. Belsky (1) for his interest in our study (2), in which we investigated associations between physical activity and cognitive function in young people. He raises several important issues on the role of physical activity as a public health strategy in the prevention of cognitive decline. The issue of “neuroselection,” wherein individuals with better cognitive function are more likely to engage in healthy behaviors such as physical activity and refrain from unhealthy ones such as smoking, is a potential source of bias in observational studies. The alternative hypothesis is that of “neuroprotection,” in which engagement in healthy behaviors is likely to lead to enhanced cognitive development. We agree that confounding by pre-existing characteristics is a general problem in any epidemiologic work. Indeed, the children in our accelerometry sample typically came from wealthier families and had parents with higher levels of education than did those excluded from the analysis. Neuroselection may also explain the associations observed between physical activity and cognitive function. Longitudinal studies provide an opportunity to investigate whether cognitive function at baseline is associated with positive health behaviors in later life. For example, children with better cognitive function demonstrate higher fitness levels in adulthood (3). One potential mechanism may be that individuals with superior cognitive function are better able to interpret and respond to health advice than are individuals with lower cognitive function (4).The basis of the neuroselection hypothesis is that individuals with higher cognitive function elect to live healthier lives. However, in our study (2), physical activity was measured at age 7 years, meaning that if the neuroselection argument were true, children with higher cognitive function would already be selecting to be active at this early age. Children’s knowledge of healthy behaviors is limited in this age group (5), which suggests that young children may not be able to correctly identify healthy behaviors regardless of cognitive ability. Moreover, during early childhood, self-selection of healthy behaviors may be restricted because of the low levels of autonomy due