社区老年人体智锻炼与轻度认知障碍患病关联性的城乡差异

廉鹏飞; 刘璋; 曾燕; 刘丹; 程桂荣; 杨萌柳; 余亚夫; 张晶晶; 周福凯; 许浪

doi:10.16462/j.cnki.zhjbkz.2023.10.003

社区老年人体智锻炼与轻度认知障碍患病关联性的城乡差异

doi: 10.16462/j.cnki.zhjbkz.2023.10.003

廉鹏飞^{1, 2},
刘璋³,
曾燕^{1, 2},
刘丹^{1, 2},
程桂荣^{1, 2},
杨萌柳^{1, 2},
余亚夫^{1, 2},
张晶晶^{1, 2},
周福凯^{1, 2},
许浪^{1, 2, ,}

1.
武汉科技大学医学院，武汉 430065
2.
武汉科技大学脑科学先进技术研究院，武汉 430065
3.
大悟县中医院，孝感 432800

基金项目:

国家重点研发计划 2020YFC2006000

国家自然科学基金 72174159

湖北省卫生健康科研基金 WJ2019H174

详细信息

通讯作者:
许浪，E-mail: xulang@wust.edu.cn

中图分类号: R181.2
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- 被引次数: 0
出版历程
- 收稿日期: 2022-09-16
- 修回日期: 2023-01-30
- 网络出版日期: 2023-10-23
- 刊出日期: 2023-10-10

Urban and rural disparities in the association between physical exercise, cognitive activity, and mild cognitive impairment in community-dwelling older adults

LIAN Pengfei^{1, 2},
LIU Zhang³,
ZENG Yan^{1, 2},
LIU Dan^{1, 2},
CHENG Guirong^{1, 2},
YANG Mengliu^{1, 2},
YU Yafu^{1, 2},
ZHANG Jingjing^{1, 2},
ZHOU Fukai^{1, 2},
XU Lang^{1, 2
, ,}

1.
Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
2.
Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan 430065, China
3.
Dawu County Hospital of Traditional Chinese Medicine, Xiaogan 432800, China

Funds:

National Key Research and Development Program of China 2020YFC2006000

National Natural Science Foundation of China 72174159

Health Commission of Hubei Province Scientific Research Project WJ2019H174

More Information

Corresponding author: XU Lang, E-mail: xulang@wust.edu.cn

摘要

摘要: 目的调查社区老年人体智锻炼与轻度认知障碍(mild cognitive impairment, MCI)患病关联性及城乡差异。方法基于湖北老年记忆队列(Hubei Memory and Aging Cohort Study, HMACS)，根据体智锻炼参与情况将社区老人分为：无锻炼(no exercise, NE)、仅体育锻炼(physical exercise only, PE)、仅智力练习(cognitive activity only, CA)和体智锻炼(physical exercise and cognitive activity, PE+CA)组。采用多因素logistic回归分析模型分析体智锻炼与MCI患病的关联性及其城乡差异。结果共纳入8 365人，平均年龄为(71.67±5.52)岁，MCI患病率为23.22%(95% CI: 22.31%~24.12%)，且农村(41.00%) 高于城市(13.61%)。PE、CA、PE+CA组人群MCI的患病风险均低于NE组(均P < 0.05)。进一步分析发现，农村PE组(OR=0.646，95% CI: 0.542~0.771)、城市CA组(OR=0.684, 95% CI: 0.487~0.961)会降低MCI的患病风险(均P < 0.05)。结论农村MCI患病率高于城市；体智锻炼会降低MCI患病风险；城乡间单一锻炼与MCI患病的关联存在不同，在制定健康老年化认知障碍类疾病干预策略时，应考虑文化背景和城乡差异。
- 老年人 /
- 体智锻炼 /
- 轻度认知障碍 /
- 患病率
Abstract: Objective The study aimed to investigate the correlation between physical exercise, cognitive activity, and mild cognitive impairment (MCI) in the community-dwelling older adults, with focus on the disparities between urban and rural areas. Methods Based on the Hubei Memory and Aging Cohort Study (HMACS), participants were divided into four groups according to the participation in exercise status: no exercise (NE), physical exercise only (PE), cognitive activity only (CA), and physical exercise and cognitive activity (PE+CA). Multivariate logistic regression model was used to analyze the correlation between the patterns of physical exercise and cognitive activity with MCI and its urban-rural disparities. Results A total of 8 365 participants were enrolled, with an average age of (71.67±5.52) years. The prevalence of MCI was 23.22% (95% CI: 22.31%-24.12%), and the MCI prevalence in rural areas was higher than that in urban areas (41.00%∶13.61%). The risk of MCI in the PE, CA, and PE+CA groups were significantly lower than that in the NE group (both P < 0.05). Further, based on the analysis of residence stratification, rural PE group (OR=0.646, 95% CI: 0.542-0.771) and urban CA group (OR=0.684, 95% CI: 0.487-0.961) significantly exhibited a lower risk of MCI (all P < 0.05). Conclusions The prevalence of MCI in rural areas is higher than that in urban areas. Physical exercise and cognitive activity will significantly reduce the risk of MCI; the correlation between single exercise patterns and MCI was different between urban and rural areas. Under the goal of healthy aging, we should take into account the cultural background of older adults and urban-rural differences when the intervention strategies for cognitive impairment diseases was formulated.
- Older adults /
- Physical exercise and cognitive activity /
- Mild cognitive impairment /
- Prevalence

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图 1 体智锻炼与MCI患病风险的关联

1.NE: 无锻炼；PE: 仅体育锻炼；CA: 仅智力练习；PE+CA: 体智锻炼。
2. a：对性别、年龄、居住地、文化程度、婚姻状况、饮酒、肥胖、高血压、糖尿病和冠心病进行了调整；b：对性别、年龄、文化程度、婚姻状况、饮酒、肥胖、高血压、糖尿病和冠心病进行了调整。

Figure 1. Association between physical exercise, cognitive activity, and the risk of MCI

1. NE: no exercise; PE: physical exercise only; CA: cognitive activity only; PE+CA: physical exercise and cognitive activity.
2. a: adjusted variables included gender, age, residence, education, marriage, drinking, obesity, hypertension, diabetes mellitus and coronary heart disease; b: adjusted variables included gender, age, education, marriage, drinking, obesity, hypertension, diabetes mellitus and coronary heart disease.

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表 1 参与者的基本特征

Table 1. General characteristics of the participants

特征Characteristics	合计^① Total ^① (n=8 365)	MCI ^① (n=1 942)	非MCI ^① Non MCI ^① (n=6 423)	χ²/ Z值 value	P值 value
性别/女Gender/female	4 474(53.48)	1 177(60.61)	3 297(51.33)	51.578	< 0.001
年龄/岁, (x± s) Age /years, (x± s)	71.67±5.52	73.16±6.00	71.22±5.29	12.980	< 0.001
居住地/农村Residence/rural	2 934(35.07)	1 203(61.95)	1 731(26.95)	801.974	< 0.001
文化水平Education				441.654	< 0.001
文盲Illiteracy	1 574(18.82)	633(32.60)	941(14.65)
小学Primary school	1 953(23.35)	533(27.45)	1 420(22.11)
中学Middle school	3 573(42.71)	642(33.05)	2 931(45.63)
大学及以上University and above	1 265(15.12)	134(6.90)	1 131(17.61)
婚姻(在婚) Marriage (being married)	5 772(69.00)	1 048(53.96)	4 724(73.55)	267.357	< 0.001
吸烟(是) Smoking (yes)	2 647(31.64)	622(32.03)	2 025(31.53)	0.173	0.677
饮酒(是) Drinking (yes)	2 633(31.48)	813(41.86)	1 820(28.34)	126.528	< 0.001
体智锻炼Exercise status				466.240	< 0.001
NE	1 929(23.06)	759(39.08)	1 170(18.22)
PE	3 589(42.90)	775(39.91)	2 814(43.81)
CA	716(8.56)	159(8.19)	557(8.67)
PE+CA	2 131(25.48)	249(12.82)	1 882(29.30)
肥胖(是) Obesity (yes)	5 713(68.30)	1 374(70.75)	4 339(67.55)	7.042	0.008
高血压(是) Hypertension (yes)	5 122(61.23)	1 250(64.37)	3 872(60.28)	10.473	0.001
糖尿病(是) Diabetes mellitus (yes)	1 539(18.40)	403(20.75)	1 136(17.69)	9.333	0.002
冠心病(是) Coronary heart disease (yes)	1 410(16.86)	389(20.03)	1 021(15.90)	18.191	< 0.001
注：NE, 无锻炼; PE, 仅体育锻炼; CA, 仅智力练习；PE+CA, 体智锻炼; MCI, 轻度认知障碍。 ①以[人数(占比/%)]表示。 Notes：NE, no exercise; PE, physical exercise only; CA, cognitive activity only; PE+CA, physical exercise and cognitive activity; MCI, mild cognitive impairment. ① [Number of people (proportion /%)].

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表 2 城乡各体智锻炼组MCI的患病情况

Table 2. Prevalence of MCI in urban and rural exercise groups

体智锻炼Exercise status	患病率(95% CI) Prevalence (95% CI)			χ_b²值value	P_b值value
体智锻炼Exercise status	总体Total	农村Rural	城市Urban	χ_b²值value	P_b值value
总体Total	23.22%(22.31%~24.12%)	41.00%(39.22%~42.78%)	13.61%(12.69%~14.52%)	801.974	< 0.001
NE	39.35%(37.16%~41.53%)	50.61%(47.81%~53.41%)	19.48%(16.54%~22.43%)	180.816	< 0.001
PE	21.59%(20.25%~22.94%)	37.21%(34.35%~40.06%)	14.68%(13.28%~16.07%)	228.918	< 0.001
CA	22.21%(19.16%~25.26%)	37.55%(31.44%~43.66%)	14.23%(11.06%~17.39%)	50.761	< 0.001
PE+CA	11.68%(10.32%~13.05%)	21.91%(17.59%~26.23%)	9.63%(8.26%~11.01%)	43.306	< 0.001
χ_a²值value	446.240	108.385	46.918
P_a值value	< 0.001	< 0.001	< 0.001
注：1. MCI, 轻度认知功能障碍; NE, 无锻炼; PE, 仅体育锻炼; CA, 仅智力练习；PE+CA, 体智锻炼。 2. χ_a²、P_a为体智锻炼分组间比较，χ_b²、P_b为城乡间比较。 Notes：1. MCI, mild cognitive impairment; NE, no exercise; PE, physical exercise only; CA, cognitive activity only; PE+CA, physical exercise and cognitive activity. 2. χ_a² and P_a indicates the comparison between groups of different exercise status, χ_b² and P_b indicates the comparison between urban-rural.

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