Associations between modifiable lifestyle factors and multidimensional cognitive health among community-dwelling old adults: stratified by educational level.
Associations between modifiable lifestyle factors and multidimensional cognitive health among community-dwelling old adults: stratified by educational level.
复制标题
社区老年人可改变的生活方式因素与多维认知健康之间的关联：按教育水平分层
DOI：
10.1017/s1041610217003076
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发表时间：
2018-10
影响因子：
7
通讯作者：
Fang Y
中科院分区：
文献类型：
--
作者：
Yuan M;Chen J;Han Y;Wei X;Ye Z;Zhang L;Hong YA;Fang Y
背景：认知是多维的，每个领域在成功的日常生活参与中发挥着独特而关键的作用。然而，对老年人多领域认知健康的关注较少，生活方式因素在每个领域的作用尚不清楚。方法：我们于2016年在中国厦门对3230名60岁以上的老年人进行了横断面研究。蒙特利尔认知评估（MoCA）用于测量一般认知和六个特定子领域。为了考虑教育的影响，我们调整了MoCA分数，并将受访者分为三个教育特定组（分别为受教育年限≤5年、6~8年和≥9年的低、中、高等教育组）。研究人员使用了一系列比例赔率模型来检测两类生活方式因素——药物滥用（香烟和酒精）和休闲活动（看电视、阅读、使用智能手机、社交活动和锻炼）——与一般认知和这三组中的六个子领域之间的关联。结果：在3230名调查对象中，纳入2617名符合条件的参与者，平均年龄69.05±7.07岁。在整个人群中，以前或现在吸烟/饮酒与MoCA得分无关，但出乎意料的是，低教育程度组的戒烟者在一般认知（or = 2.22）和注意力（or = 2.05）方面的表现优于不吸烟的对照组。适度看电视、阅读和使用智能手机也有助于低教育程度组的老年人更好地认知。高学历老年人较长的阅读时间（3.5小时/周）与一般认知（OR = 0.53）、记忆（OR = 0.59）、语言（OR = 0.54）呈负相关，而充足的运动（5~7天/周）与这些因素呈正相关，分别为OR = 1.48、OR = 1.49、OR = 1.53。对于受教育程度中等的老年人来说，只有适度的阅读才有显著的益处。结论：生活方式因素在不同教育群体多维认知健康中的作用不同，应根据不同教育群体和不同认知子域设计个体干预策略。
ABSTRACT Background: Cognition is multidimensional, and each domain plays a unique and crucial part in successful daily life engagement. However, less attention has been paid to multi-domain cognitive health for the elderly, and the role of lifestyle factors in each domain remains unclear. Methods: We conducted a cross-sectional study of 3,230 older adults aged 60+ years in Xiamen, China, in 2016. The Montreal Cognitive Assessment (MoCA) was used to measure general cognition and six specific sub-domains. To account for educational effects, we adjusted the MoCA score and divided respondents into three education-specific groups (low, moderate, and high education groups with ≤5, 6~8, and ≥9 years of education, respectively). A series of proportional odds models were used to detect the associations between two categories of lifestyle factors – substance abuse (cigarette and alcohol) and leisure activity (TV watching, reading, smartphone use, social activity, and exercise) – and general cognition and the six sub-domains in those three groups. Results: Among the 3,230 respondents, 2,617 eligible participants were included with a mean age of 69.05 ± 7.07 years. Previous or current smoking/drinking was not associated with MoCA scores in the whole population, but unexpectedly, the ex-smokers in the low education group performed better in general cognition (OR = 2.22) and attention (OR = 2.05) than their never-smoking counterparts. Modest TV watching, reading, and smartphone use also contributed to better cognition among elderly participants in the low education group. For the highly educated elderly, comparatively longer reading (>3.5 hours/week) was inversely associated with general cognition (OR = 0.53), memory (OR = 0.59), and language (OR = 0.54), while adequate exercise (5~7 days/week) was positively related to these factors with OR = 1.48, OR = 1.49, and OR = 1.53, respectively. For the moderately educated elderly, only modest reading was significantly beneficial. Conclusions: Lifestyle factors play different roles in multidimensional cognitive health in different educational groups, indicating that individual intervention strategies should be designed according to specific educational groups and different cognitive sub-domains.