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广东省广州市社区≥65岁老年人身体–脑力双重锻炼与轻度认知障碍患病关联性研究

Association between physical and mental exercises and mild cognitive impairment in the elderly aged ≥65 years in communities in Guangzhou, Guangdong

    摘要
  • 摘要:
    目的 了解广东省广州市社区≥65岁老年人轻度认知障碍（MCI）的现况，探究其与身体-脑力双重锻炼的关联性，为有关政策和措施的制定与实施提供有力支撑。
    方法  采用多阶段整群随机抽样方法，对广州市社区≥65岁的常住居民进行面对面问卷调查，收集研究对象的一般人口学特征、健康相关行为、慢性病患病情况等信息。 采用χ2检验和二元logistic回归分析身体–脑力双重锻炼与MCI患病的关联性。
    结果  广州市社区≥65岁老年人MCI患病率为23.78%（274/1 152）。 调整性别、年龄、文化程度、退休前职业、婚姻状况、饮酒、吸烟、居住地、高血压、脑卒中等变量后，进行单一（仅身体/仅脑力）锻炼［比值比（OR）=0.52，95%置信区间（CI）：0.27～0.97］和身体–脑力双重锻炼（OR=0.30，95%CI：0.15～0.58）的老年人比无锻炼的老年人发生MCI的风险降低。 进一步亚组分析发现，与男性老年人相比，进行单一锻炼对MCI的保护作用在女性老年人中更为显著（OR=0.41，95%CI：0.18～0.89）。 无论性别，老年人进行身体–脑力双重锻炼能够降低MCI发生的风险（P＜0.05）。 通过年龄亚组分析发现，与无锻炼相比，进行身体–脑力双重锻炼能明显降低各年龄段老年人MCI的患病风险（均P＜0.05）。 与70～<80岁、≥80岁年龄组相比，单一锻炼在65～<70岁年龄组老年人中效果更显著（OR=0.30，95%CI：0.10～0.92）。
    结论 广州市社区≥65岁老年人进行身体–脑力双重锻炼能够降低MCI患病风险；不同性别、不同年龄老年人进行身体–脑力双重锻炼与MCI患病的关联不同。 因此，在制定MCI防控策略时，应当考虑设计合适的双重锻炼方案。

     

    Abstract:
    Objective To understand the prevalence of mild cognitive impairment (MCI) in the elderly aged ≥65 years in communities in Guangzhou, Guangdong province, explore its correlation with physical and mental exercises, and provide data support for the development of relevant policies and measures.
    Methods A multi-stage cluster random sampling method was used to select study subjects for a face-to-face questionnaire survey of the individual characteristics, health-related behaviors and chronic disease prevalence in the residents aged ≥65 years in communities in Guangzhou. The correlation between physical and mental exercises and MCI was analyzed by χ2 test and logistic regression model.
    Results In communities in Guangzhou, the prevalence rate of MCI in the elderly aged ≥65 years was 23.78% (274/1 152). After adjusting for sex, age, education level, occupation, marital status, alcohol use, smoking, place of residence, hypertension, and stroke, the elderly who took either physical excises or mental exercise odds ratio (OR)=0.52, 95% confidence interval (CI): 0.27–0.97 and both physical excises and mental exercise (OR=0.30, 95%CI: 0.15–0.58) had lower risk for MCI than those who took no exercise. Further subgroup analysis showed that, compared with men, the protective effect of either physical excises or mental exercise (OR=0.41, 95%CI: 0.18–0.89) against MCI was more significant in women. Regardless of gender, physical and mental exercises could reduce the risk for MCI in the elderly (P<0.05). By age stratification, it was found that physical and mental exercises could significantly reduce the incidence of MCI in the elderly in all age groups (P<0.05). Taking either physicalexcises or mental exercise had stronger protective effect in age group 65–<70 years than in age groups 70–<80 years and ≥80 years (OR=0.30, 95%CI: 0.10–0.92).
    Conclusion Physical and mental exercises reduced the risk for MCI in the elderly aged ≥65 years in communities in Guangzhou, and the association of physical and mental exercises with MCI differed with age and gender in the elderly. Therefore, it is necessary to consider designing suitable physical and mental exercise programs in the development of MCI prevention and treatment strategies in the elderly.

     

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