Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older
Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older
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DOI：
10.7326/0003-4819-144-2-200601170-00004
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发表时间：
2006-01-17
影响因子：
39.2
通讯作者：
Kukull, W
中科院分区：
文献类型：
--
作者：
Larson, EB;Wang, L;Kukull, W
背景：阿尔茨海默病和其他痴呆症是老龄化社会发病率和死亡率的主要来源。经过验证的延迟痴呆症发作或降低痴呆症风险的策略将非常有益。目的：确定定期锻炼是否与降低痴呆症和阿尔茨海默病的风险有关。设计：前瞻性队列研究。地点：团体健康合作社，西雅图，华盛顿。参会人员：1740名年龄超过65岁的无认知障碍的人，在成人思维变化研究中的认知能力筛查工具（CASI）上得分高于第25百分位，每两年随访一次，以确定痴呆事件。测量：基线测量，包括运动频率、认知功能、身体功能、抑郁、健康状况、生活方式特征，和其他潜在的风险因素痴呆症（例如，载脂蛋白E EURO 4），两年一次的评估demential.Results：在平均随访6.2年（SD，2.0），158名参与者发展痴呆症（107发展阿尔茨海默病）。每周锻炼3次或以上的参与者的痴呆症发病率为13.0/1000人年，而每周锻炼少于3次的参与者为19.7/1000人年。年龄和性别校正的痴呆风险比为0.62（95%CI，0.44至0.86; P = 0.004）。运动和基于性能的身体功能之间的相互作用具有统计学意义（P = 0.013）。与运动相关的风险降低在那些表现水平较低的人中更大。在仅限于阿尔茨海默病患者的分析中观察到类似的结果。局限性：运动是通过自我报告的频率来衡量的。研究人群有一个相对较高的比例，经常锻炼者在baseline.Conclusion：这些结果表明，经常锻炼与痴呆症和阿尔茨海默病的发病延迟，进一步支持其价值为老年人。
Background: Alzheimer disease and other dementing disorders are major sources of morbidity and mortality in aging societies. Proven strategies to delay onset or reduce risk for dementing disorders would be greatly beneficial.Objective: To determine whether regular exercise is associated with a reduced risk for dementia and Alzheimer disease.Design: Prospective cohort study.Setting: Group Health Cooperative, Seattle, Washington. Participants: 1740 persons older than age 65 years without cognitive impairment who scored above the 25th percentile on the Cognitive Ability Screening Instrument (CASI) in the Adult Changes in Thought study and who were followed biennially to identify incident dementia.Measurements: Baseline measurements, including exercise frequency, cognitive function, physical function, depression, health conditions, lifestyle characteristics, and other potential risk factors for dementia (for example, apolipoprotein E EURO4); biennial assessment for dementia.Results: During a mean follow-up of 6.2 years (SD, 2.0), 158 participants developed dementia (107 developed Alzheimer disease). The incidence rate of dementia was 13.0 per 1000 person-years for participants who exercised 3 or more times per week compared with 19.7 per 1000 person-years for those who exercised fewer than 3 times per week. The age- and sex-adjusted hazard ratio of dementia was 0.62 (95% Cl, 0.44 to 0.86; P = 0.004). The interaction between exercise and performance-based physical function was statistically significant (P = 0.013). The risk reduction associated with exercise was greater in those with lower performance levels. Similar results were observed in analyses restricted to participants with incident Alzheimer disease.Limitations: Exercise was measured by self-reported frequency. The study population had a relatively high proportion of regular exercisers at baseline.Conclusion: These results suggest that regular exercise is associated with a delay in onset of dementia and Alzheimer disease, further supporting its value for elderly persons.