卫生研究

目的分析不同强度身体活动时间与认知功能之间的关系。方法以2018—2019年"神经系统疾病专病社区队列研究"基线调查数据为依托,采用多阶段分层整群随机抽样的方法在河北、浙江、陕西及湖南省选取5571名有完整人口学信息、身体活动以及认知功能资料的55岁及以上人群作为研究对象。采用问卷调查法收集研究对象基础信息和身体活动(physical activity, PA)等数据。通过蒙特利尔认知评估量表(the Montreal cognitive assessment,MoCA)评分方法评估认知功能,计算每周低强度(light physical activity, LPA)和中高强度身体活动(moderate-to-vigorous physical activity, MVPA)时间。采用多因素Logistic回归和多元线性回归,分别分析不同强度PA时间与轻度认知功能障碍(mild cognitive impairment, MCI)的患病风险,以及与MoCA总分的关系。结果 2018年中国四省5571名55岁及以上人群身体活动时间以中位数(P25,P75)表示,非MCI组每周LPA时间为7.0(0.0,16.3)小时,每周MVPA时间为7.3(0.0,14.0)小时;MCI组每周LPA时间为9.3(0.0,17.5)小时,每周MVPA时间为7.0(0.0,11.7)小时。Logistic回归分析显示,与MVPA时间为0小时的人群相比,每周MVPA时间达到3.6～7.0小时的人群MCI患病风险相对危险度为0.63(95%CI 0.49～0.82,P<0.05)。与LPA时间为0小时的人群相比,每周LPA时间达到3.6～7.0小时人群MCI患病风险相对危险度为1.26(95%CI 0.94～1.67,P>0.05)。多元线性回归分析显示,与每周MVPA时间为0小时的人群相比,随着MVPA时间增加,MoCA总分增加。与每周LPA时间为0小时的人群相比,每周LPA时间小于10.5小时的人群MoCA总分随着每周LPA时间增加而增加。每周LPA时间达到10.5～21.0小时的人群,MoCA总分随着每周LPA时间增加而减少。结论中国四省55岁及以上人群MVPA时间的增加与MCI患病率下降和认知功能检查得分增加有关。LPA时间在适宜范围内,与MCI患病率下降和认知功能检查得分增加有关。

OBJECTIVE To analyze the relationship between different intensity of physical activity(PA) duration and cognitive function. METHODS The 2018 Community-based Cohort Study on Nervous System Diseases used multi-stage stratified cluster randomization sampling method to select study participants. A total of 5571 participants aged 55 years and above from four provinces in China with complete information on demographic characteristics and PA and cognitive function were included in the final analysis. Basic information and PA data were collected by questionnaire. The Montreal cognitive assessment(MoCA) score method was adopted to evaluate the cognitive function. Light physical activity(LPA) duration and moderate-to-vigorous physical activity(MVPA) duration were calculated. Multivariate Logistic regression and Multiple linear regressions were used to analyze the relationship between different intensity of PA duration and the risk of mild cognitive impairment(MCI) and MoCA total score. RESULTS The median(P25,P75) of LPA and MVPA were 7.0(0.0, 16.3) and 7.3(0.0,14.0) hours per week in the non-MCI group among 5571 participants aged 55 years and above in four provinces of China in 2018. In the MCI group, the median duration were 9.3(0.0,17.5) and 7.0(0.0,11.7) hours per week. The Logistic analysis showed that the OR of MCI was 0.63(95%CI 0.49-0.82,P<0.05) for the elderly with 3.6-7.0 hours of MVPA per week, compared to the elderly without MVPA.The OR of MCI was 1.26(95%CI 0.94-1.67,P>0.05) for the elderly with 3.6-7.0 hours of LPA per week compared to the elderly without LPA. Multiple linear regression analysis showed that compared to the elderly without MVPA, the total MoCA score increased with LPA duration increased as the duration was less than 10.5 hours per week. The MoCA score decreased with LPA duration increased as duration was between 10.5 and 21.0 hours per week. CONCLUSION MVPA duration increment was associated with decreased prevalence of MCI and increased cognitive function in the elderly in four provinces of China. LPA duration should be maintained at an appropriate level in order to reduce the incidence of MCI and increased cognitive function in the elderly.