Participation in cognitively stimulating activities and risk of incident Alzheimer disease
Participation in cognitively stimulating activities and risk of incident Alzheimer disease
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DOI：
10.1001/jama.287.6.742
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发表时间：
2002-02-13
影响因子：
120.7
通讯作者：
Bennett, DA
中科院分区：
文献类型：
--
作者：
Wilson, RS;de Leon, CFM;Bennett, DA
背景 频繁参与认知刺激活动已被假设可降低阿尔茨海默病 (AD) 的风险，但缺乏有关关联的前瞻性数据。目的 检验频繁参与认知活动与降低 AD 风险相关的假设。设计纵向队列研究，在 1994 年 1 月至 2001 年 7 月期间进行基线评估，平均随访 4.5 年。参与者和环境 从美国各地的 40 个团体中招募了 801 名在入学时没有患有痴呆症的老年天主教修女、牧师和兄弟。在基线时，他们对参与常见认知活动（例如阅读报纸）的频率进行了评估，从中得出了先前验证的认知活动频率的综合测量结果。 主要结果测量 由委员会认证的神经科医生使用国家神经和交流障碍研究所以及中风/阿尔茨海默氏病和相关疾病协会标准对 AD 进行临床诊断，并比较认知功能的整体和特定测量的变化 结果认知活动综合测量的基线得分范围为 1.57 至 4.71（平均值为 3.57；标准差为 0.55），得分越高表明活动越频繁。在平均 4.5 年的随访中，111 人患上了 AD。在控制了年龄、性别和教育程度的比例风险模型中，认知活动得分每增加 1 分，AD 风险就会降低 33%（风险比，0.67；95% 置信区间，0.49-0.92）。当排除基线时有记忆障碍的人并添加载脂蛋白 E epsilon4 等位基因和其他医疗状况的术语时，结果具有可比性。在控制年龄、性别、教育程度和认知功能基线水平的随机效应模型中，认知活动每增加 1 个百分点，与整体认知（减少 47%）、工作记忆（减少 60%）和知觉速度（减少 30%）的下降减少相关。 结论 这些结果表明，频繁参与认知刺激活动与 AD 风险降低相关。
Context Frequent participation in cognitively stimulating activities has been hypothesized to reduce risk of Alzheimer disease (AD), but prospective data regarding an association are lacking.Objective To test the hypothesis that frequent participation in cognitive activities is associated with a reduced risk of AD.Design Longitudinal cohort study with baseline evaluations performed between January 1994 and July 2001 and mean follow-up of 4.5 years.Participants and Setting A total of 801 older Catholic nuns, priests, and brothers without dementia at enrollment, recruited from 40 groups across the United States. At baseline, they rated frequency of participation in common cognitive activities (eg, reading a newspaper), from which a previously validated composite measure of cognitive activity frequency was derived.Main Outcome Measures Clinical diagnosis of AD by a board-certified neurologist using National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association criteria and change in global and specific measures of cognitive function, compared by cognitive activity scare at baseline.Results Baseline scores on the composite measure of cognitive activity ranged from 1.57 to 4.71 (mean, 3.57; SD, 0.55), with higher scores indicating more frequent activity. During an average of 4.5 years of follow-up, 111 persons developed AD. In a proportional hazards model that controlled for age, sex, and education, a 1-point increase in cognitive activity score was associated with a 33% reduction in risk of AD (hazard ratio, 0.67; 95% confidence interval, 0.49-0.92). Results were comparable when persons with memory impairment at baseline were excluded and when terms for the apolipoprotein E epsilon4 allele and other medical conditions were added. in random-effects models that controlled for age, sex, education, and baseline level of cognitive function, a 1-point increase in cognitive activity was associated with reduced decline in global cognition (by 47%), working memory (by 60%), and perceptual speed (by 30%).Conclusion These results suggest that frequent participation in cognitively stimulating activities is associated with reduced risk of AD.