摘要
目的分析生活方式对西安市农村40岁及以上人群认知功能下降的影响。方法本研究为前瞻性队列研究,选择西安市鄠邑区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年、2018年进行2次随访。根据吸烟、饮酒、运动及饮食等计算生活方式综合评分。采用简易精神状态量表(Mini-Mental State Examination,MMSE)评估基线及随访时整体认知功能,MMSE评分较基线下降(ΔMMSE)≥4分定义为认知功能显著下降。利用单因素、多因素Logistic回归及倾向性评分等方法分析生活方式与认知功能下降的关系。结果最终纳入分析1348人,其中基线符合认知功能显著下降标准56人(4.2%);有吸烟史386人(28.6%),饮酒184人(13.6%),缺乏体育锻炼214人(15.9%),饮食重油盐400人(29.7%),符合不健康生活方式标准(综合评分<6分)304人(22.6%)。多因素Logistic回归分析显示,不健康生活方式人群认知功能显著下降的风险较高(OR=2.838,95%CI:1.302~5.525,P=0.005)。敏感性分析中,采用倾向性评分校正,分析结果一致(OR=2.786,95%CI:1.371~5.661,P=0.005);采用倾向性评分匹配进一步平衡两组间协变量差异(所有协变量的标准化均值差异均小于0.1)后,多因素Logistic回归分析提示,不健康生活方式与认知功能显著下降相关(OR=3.994,95%CI:1.582~12.176,P=0.006)。结论在40岁及以上认知正常人群中,不健康生活方式增加认知功能下降的风险。
Objective To investigate the effect of lifestyle on cognitive decline in rural people aged 40 years and older in Xi’an.Methods This was a prospective cohort study.People aged 40 years and older in two villages in Huyi District were selected as the study population.They completed the baseline survey from October 2014 to March 2015 as well as two follow-up visits in 2016 and 2018,respectively.A comprehensive score of lifestyle was calculated based on factors including smoking,drinking,exercise,and diet collected at the baseline.The Mini-Mental State Examination(MMSE)was used to evaluate global cognitive function at both baseline and follow-up;a≥4-point decrease in MMSE score from the baseline was defined as marked cognitive decline.Multivariable Logistic regression,propensity score correction,and propensity score matching were used to investigate the relationship between lifestyle and cognitive decline.Results A total of 1348 participants were ultimately enrolled and 56(4.2%)of them met the criteria for marked cognitive decline(ΔMMSE≥4-points).Among them,386(28.6%)people had smoking history,184(13.6%)were drinkers,214(15.9%)lacked physical activity,and 400(29.7%)ate a diet high in oil and salt.Generally,304(22.6%)met the definition of the unhealthy lifestyle(comprehensive score<6),which means more than one of the four subscales was unhealthy or more than two were relatively unhealthy.Multivariable Logistic regression analysis showed that unhealthy lifestyle was positively associated with marked cognitive decline(OR=2.838,95%CI:1.302-5.525,P=0.005).Propensity-score adjusted model yielded very similar results(OR=2.786,95%CI:1.371-5.661,P=0.005).Propensity score matching was performed to further balance the differences in covariates between the two groups.Multivariate Logistic regression analysis conducted in the matched population revealed that the risk of marked cognitive decline was still higher in those with unhealthy lifestyle(OR=3.994,95%CI:1.582-12.176,P=0.006).Conclusion Unhealthy lifestyle is associated with an increased risk of cognitive decline in cognitively normal people aged 40 years and older.
作者
周蓉
张彧
曹红梅
商苏杭
党亮君
魏珊
王敬谊
屈秋民
屈彦
ZHOU Rong;ZHANG Yu;CAO Hongmei;SHANG Suhang;DANG Liangjun;WEI Shan;WANG Jingyi;QU Qiumin;QU Yan(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775-782,共8页
Journal of Xi’an Jiaotong University(Medical Sciences)
基金
科技创新-2030(No.2021ZD0201808)
国家自然科学基金资助(No.82301364,No.82201580)
陕西省自然科学基础研究计划项目(No.2021JM-277)。
作者简介
通信作者:屈彦,副主任护理师.E-mail:quyan1178@xjtufh.edu.cn;第一作者:周蓉;共同第一作者:张彧。
