Behavioural change, weight loss and risk of dementia: A longitudinal study.
Behavioural change, weight loss and risk of dementia: A longitudinal study.
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DOI：
10.1016/j.ypmed.2020.106386
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发表时间：
2020-12
影响因子：
5.1
通讯作者：
T. Astell‐Burt;M. Navakatikyan;Xiaoqi Feng
中科院分区：
文献类型：
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作者：
T. Astell‐Burt;M. Navakatikyan;Xiaoqi Feng
最近的荟萃分析报告称，较高的痴呆风险与较低的体重指数 (BMI) 和体重指数下降相关。我们研究了这些关联在多大程度上因行为和当地环境的变化而减弱。多级离散事件发生时间模型检查了基线和 BMI 变化与通过处方药检测到的痴呆症（来源：人类服务部）、萨克斯研究所 45 岁及以上研究的 144,456 名参与者的住院和死亡证明之间的关联。模型根据社会经济因素和遵守已发布的中度至剧烈体力活动指南、睡眠时间、酒精、水果和蔬菜消费、心脏代谢疾病的发病率以及地区弱势和农村指标的变化指标进行了调整。数据于 2020 年进行分析。发现体重不足（发病风险比 (IHR) 1.30，95%CI=0.86–1.86）的参与者患痴呆症的风险较高（尽管不精确），超重（IHR=0.78，95%CI=0.70–0.86）或肥胖（IHR=0.72，95%CI=0.70–0.86）的参与者痴呆风险较低。 95% CI=0.62–0.83）与“正常”BMI 相比。与 BMI 稳定的人相比，与 IHR 相关的 BMI 降低 ≥0.8 kg/m2=1.81 (95%CI=1.64–2.01) 痴呆风险更高。相对于基线 BMI 类别，随着 BMI 降低，痴呆风险较高，相当一致。遵守体力活动和睡眠时间指南与降低痴呆风险相关，但这些以及对其他行为和局部因素的调整都不能解释 BMI 与痴呆之间的关联。总之，我们复制了最近一项荟萃分析中的 BMI 痴呆研究结果，并为侧重于增加体力活动和改善睡眠时间的预防策略提供了进一步支持。社会经济和城乡环境之外的其他潜在环境风险因素值得调查。
Recent meta-analysis reported higher dementia risks associated with lower body mass index (BMI) and decreasing BMI. We examined to what extent these associations were attenuated by changes in behaviours and local environment. Multilevel discrete time-to-event models examined associations between baseline and change in BMI with dementia detected through prescription medications (source: Department of Human Services), hospitalisations and death certificates among 144,456 participants in the Sax Institute's 45 and Up Study. Models were adjusted for socioeconomic factors and measures of change in adherence to published guidelines for moderate to vigorous physical activity, sleep duration, alcohol, and fruit and vegetable consumption, as well as incidence of cardiometabolic diseases, and indicators of area-level disadvantage and rurality. Data was analysed in 2020. Higher dementia risks (albeit with imprecision) were found among participants who were underweight (Incidence Hazard Ratio (IHR) 1.30, 95%CI=0.86–1.86) and lower risks among those who were overweight (IHR=0.78, 95%CI=0.70–0.86) or obese (IHR=0.72, 95%CI=0.62–0.83) compared with ‘normal’ BMI. A ≥0.8 kg/m2 reduction in BMI associated with IHR=1.81 (95%CI=1.64–2.01) higher dementia risk relative to those with stable BMI. Higher dementia risk with decreasing BMI was fairly consistent relative to baseline BMI category. Adherence to physical activity and sleep duration guidelines were associated with reduced dementia risk, but neither these, nor adjustment for other behaviours and local factors, explained the BMI-dementia association. In conclusion, we replicated the BMI-dementia findings from a recent meta-analysis and provide further support to preventive strategies focussed on increasing physical activity and improving sleep duration. Other potential environmental risk factors outside of socioeconomic and urban/rural circumstances warrant investigation.