The Effects of "Diet-Smoking-Gender" Three-Way Interactions on Cognitive Impairment among Chinese Older Adults.
The Effects of "Diet-Smoking-Gender" Three-Way Interactions on Cognitive Impairment among Chinese Older Adults.
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作者：
需要对认知障碍风险因素的性别差异进行调查，以促进未来老年人的精准医疗，并有助于更好地理解“男女健康-生存悖论”。本研究旨在探讨饮食-吸烟-性别三因素交互作用对中国老年人认知功能障碍的影响。我们在2002年、2005年、2008-2009年、2011-2012年、2014年和2017-2018年中国健康长寿纵向调查（CLHLS）的15，953、15，555、16，849、9716、7116和13，165名老年人中进行了一项为期16年的前瞻性队列研究。认知功能障碍通过简易精神状态检查（MMSE）进行测量。使用CLHLS食物频率问卷计算饮食多样性评分（DDS）。使用广义估计方程（GEE）评估“饮食-吸烟-性别”三向交互作用对CLHLS六个波中认知障碍的影响。我们发现，在老年人中，饮食多样性越高，认知障碍的概率越低（OR = 0.92; 95%CI = 0.90，0.98）。然而，吸烟行为可能会影响女性较高的膳食多样性对认知功能的保护作用（OR = 1.26; 95%CI = 1.07，1.49）。我们的研究结果表明，我们应该考虑性别差异和生活方式行为，在实施饮食干预，以改善老年人的认知功能。
Investigations on gender variations in the risk factors of cognitive impairment are required to promote future precision medicine among older adults, as well as to contribute to a better understanding of the “male–female health-survival paradox”. With this study, we aimed to investigate the effects of “diet–smoking–gender” three-way interactions on cognitive impairments among Chinese older adults. We conducted a 16-year prospective cohort study among 15,953, 15,555, 16,849, 9716, 7116, and 13,165 older adults from the 2002, 2005, 2008–2009, 2011–2012, 2014, and 2017–2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), respectively. Cognitive impairment was measured by the Mini-Mental State Examination (MMSE). The dietary diversity score (DDS) was calculated using the CLHLS food frequency questionnaire. Generalized estimating equations (GEE) were used to assess the “diet–smoking–gender” three-way interaction effects on cognitive impairment across the six waves of CLHLS. We found that higher dietary diversity was associated with lower probability of cognitive impairment among older adults (OR = 0.92; 95%CI = 0.90, 0.98). However, smoking behavior may negatively influence the protective effect of higher dietary diversity on cognitive function among females (OR = 1.26; 95%CI = 1.07, 1.49). Our findings imply that we should take gender differences and lifestyle behaviors into consideration in implementing dietary interventions to improve cognitive function among older adults.
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