摘要
目的通过西安农村中老年人群队列,研究西安市农村地区40岁及以上人群吸烟与4年认知功能下降的关系。方法数据来源于西安市农村地区中老年人群认知障碍队列,选择西安市鄠邑区某2个自然村≥40岁人群为研究对象,于2014年10月—2015年3月完成基线调查,于2016、2018年进行2次随访。以该队列基线认知正常人群为研究对象,根据2018年调查结果,将人群根据吸烟状况分为吸烟、已戒烟、不吸烟3组。认知功能通过简易精神状态量表(MMSE)进行评分,将ΔMMSE(2014年评分-2018年评分)≥2分定义为认知功能下降,将ΔMMSE评分<2分定义为认知功能稳定。采用二元Logistic回归模型和分层分析,研究吸烟与认知功能下降的关系以及年龄对两者关系的影响。结果共纳入1289例受试者,不吸烟组910例(70.6%),吸烟组335例(26.0%),已戒烟组44例(3.4%)。在总人群中,不吸烟组、吸烟组、已戒烟组认知功能下降发生率无统计学差异(17.3%vs.16.1%vs.15.9%,P=0.880)。按年龄分层分析发现,在年龄<65岁亚组人群中,3组间认知功能下降发生率无统计学差异(16.5%vs.13.2%vs.12.1%,P=0.365)。在年龄≥65岁亚组人群中,不吸烟组、吸烟组、已戒烟组3组间认知功能下降发生率无统计学差异(20.8%vs.30.9%vs.27.3%,P=0.306),多因素分析校正混杂因素显示,与不吸烟组相比,吸烟组认知功能下降风险显著升高(OR=14.139;95%CI:1.541~129.705;P=0.019),戒烟组认知功能下降风险有升高的趋势,但是无统计学差异(OR=8.252;95%CI:0.630~108.175;P=0.108)。结论吸烟与老年人群认知功能下降风险正相关,提示吸烟可能加快老年人认知功能衰退。
Objective Smoking is an important risk factor for cognitive impairment,but the relationship between smoking and cognitive decline remains unclear.This study examined the association between smoking and cognitive decline through a cohort in rural population in Xi’an.Methods Data were collected from the cognitive impairment cohort of middle-aged and elderly people in rural areas of Xi’an.The cohort selected the population aged 40 years and above in rural Xi’an.The baseline survey was completed between October 2014 and March 2015,and two follow-up visits were conducted in 2016 and 2018.This study took the baseline cognitively normal population of this cohort as the research subjects.According to the survey results in 2018,the population was divided into three groups according to smoking status:smoking,quitting and non-smoking.Cognitive function was assessed by Mini-Mental State Examination(MMSE).ΔMMSE(2014 rating-2018 rating)≥2 was defined as cognitive decline,andΔMMSE<2 was defined as cognitive stability.Binary Logistic regression model and stratified analysis were used to analyze the relationship between smoking and cognitive decline and the influence of age on the relationship.Results A total of 1289 subjects were included in this study.According to smoking status in 2018,they were divided into non-smokers(910,70.6%),smokers(335,26.0%),and ex-smokers(44,3.4%).In the total population,there was no significant difference in the incidence of cognitive decline among non-smokers,smokers and ex-smokers(17.3%vs.16.1%vs.15.9%,P=0.880).When stratified by age,there was no significant difference in the incidence of cognitive decline among the three groups in the subgroup of age<65 years(16.5%vs.13.2%vs.12.1%,P=0.365).In the subgroup of age≥65 years,no significant difference was found in the incidence of cognitive decline among non-smokers,smokers and ex-smokers(20.8%vs.30.9%vs.27.3%,P=0.306).After adjusting for confounding factors,smokers had a significantly higher risk of cognitive decline than non-smokers(OR=14.139;95%CI:1.541-129.705;P=0.019).There was a trend of cognitive decline in the ex-smokers group,but with no statistical significance(OR=8.252;95%CI:0.630-108.175;P=0.108).Conclusion Smoking is positively associated with cognitive decline in the elderly,suggesting that smoking may accelerate cognitive decline in this population.
作者
刘洁
王子晗
郭晓娟
商苏杭
陈晨
王敬谊
屈秋民
王瑾
LIU Jie;WANG Zihan;GUO Xiaojuan;SHANG Suhang;CHEN Chen;WANG Jingyi;QU Qiumin;WANG Jin(Department of Neurology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061;Department of Encephalopathy,Huyi Hospital of Traditional Chinese Medicine,Xi’an 710300,China)
出处
《西安交通大学学报(医学版)》
北大核心
2025年第5期769-774,共6页
Journal of Xi’an Jiaotong University(Medical Sciences)
基金
国家科技部科技创新2030-“脑科学与类脑研究”重大项目(No.2021ZD0201808)
国家自然科学基金青年科学基金项目(No.82301364,No.82201580)。
作者简介
通信作者:王瑾,副主任医师.E-mail:drwangjin@xjtufh.edu.cn;第一作者:刘洁;共同第一作者:王子晗。
