Association Between Mentally Stimulating Activities in Late Life and the Outcome of Incident Mild Cognitive Impairment, With an Analysis of the APOE ε4 Genotype.
Association Between Mentally Stimulating Activities in Late Life and the Outcome of Incident Mild Cognitive Impairment, With an Analysis of the APOE ε4 Genotype.
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DOI：
10.1001/jamaneurol.2016.3822
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发表时间：
2017-03-01
期刊：
影响因子：
29
通讯作者：
Geda YE
中科院分区：
文献类型：
--
作者：
Krell-Roesch J;Vemuri P;Pink A;Roberts RO;Stokin GB;Mielke MM;Christianson TJ;Knopman DS;Petersen RC;Kremers WK;Geda YE
我们和其他人报告了精神刺激活动与轻度认知障碍 (MCI) 或阿尔茨海默病几率降低之间的横向关联。然而，对于通过晚年（年龄≥70岁）精神刺激活动预测的MCI事件的纵向结果知之甚少。检验我们关于晚年精神刺激活动与 MCI 事件风险之间关联的假设，并另外评估 APOE ε4 基因型的影响。前瞻性队列研究。明尼苏达州奥姆斯特德县基于人群的梅奥诊所老龄化研究。我们对 1929 名年龄≥ 70 岁的参与者进行了随访，这些参与者在 MCI 事件的结果基线时认知正常。在基线时，参与者提供了参加研究前一年内有关精神刺激活动的信息。神经认知评估在基线和 15 个月间隔评估中进行。认知诊断是由专家共识小组根据公布的标准做出的。在调整年龄、性别和教育程度后，我们使用 Cox 比例风险模型计算了风险比 (HR) 和 95% 置信区间 (95% CI)。在中位随访 4 年期间，我们观察到玩游戏（HR [95% CI]，0.78 [0.65–0.95]）、从事手工活动（0.72 [0.57–0.90]）、使用计算机（0.70 [0.57–0.85]）和社交活动（0.77 [0.63–0.94]）与事故风险降低相关MCI。在按 APOE ε4 状态进行的分层分析中，数据表明，从事精神刺激活动的 APOE ε4 非携带者发生 MCI 事件的风险最低，而不从事精神刺激活动的 APOE ε4 携带者发生 MCI 事件的风险最高。认知正常的老年人，即使在晚年，参与特定的精神刺激活动，发生 MCI 的风险也会降低。这些关联可能因 APOE ε4 携带者状态而异。
We and others have reported cross-sectional associations between mentally stimulating activities and decreased odds of having mild cognitive impairment (MCI) or Alzheimer’s disease. However, little is known about the longitudinal outcome of incident MCI as predicted by late life (age ≥70 years) mentally stimulating activities. To test our hypothesis on the association between mentally stimulating activities in late life and the risk of incident MCI and additionally evaluate the impact of APOE ε4 genotype. Prospective cohort study. Population-based Mayo Clinic Study of Aging in Olmsted County, Minnesota. We followed 1929 participants aged ≥ 70 years who were cognitively normal at baseline to the outcome of incident MCI. At baseline, participants provided information about mentally stimulating activities within a year prior to enrolment into the study. Neurocognitive assessment was conducted at baseline and 15 month interval evaluations. Cognitive diagnosis was made by an expert consensus panel based on published criteria. We calculated hazard ratios (HR) and 95% confidence intervals (95% CI) using Cox proportional hazards models after adjusting for age, sex and education. Over a median follow-up period of 4 years, we observed that playing games (HR [95% CI], 0.78 [0.65–0.95]), and engaging in craft activities (0.72 [0.57–0.90]), computer use (0.70 [0.57–0.85]), and social activities (0.77 [0.63–0.94]) were associated with a decreased risk of incident MCI. In a stratified analysis by APOE ε4 status, the data points towards the lowest risk of incident MCI for APOE ε4 non-carriers who engage in mentally stimulating activities and towards the highest risk of incident MCI for APOE ε4 carriers who do not engage in mentally stimulating activities. Cognitively normal elderly individuals who engage in specific mentally stimulating activities, even in late life, have a decreased risk of incident MCI. The associations may vary by APOE ε4 carrier status.