中国中老年人群体力活动和认知功能的关系：膳食的调节作用

赵彩凤; 董玮仲; 徐珊珊; 胡亮

doi:10.16462/j.cnki.zhjbkz.2024.10.004

中国中老年人群体力活动和认知功能的关系：膳食的调节作用

doi: 10.16462/j.cnki.zhjbkz.2024.10.004

赵彩凤¹,
董玮仲¹,
徐珊珊¹,
胡亮^{1, 2, ,}

1.
浙江大学教育学院体育学系，杭州 310058
2.
浙江大学教育学院数字体育与健康实验室，杭州 310058

详细信息

通讯作者:
胡亮，E-mail：lianghu@zju.edu.cn

中图分类号: R153.3;G806
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- 文章访问数: 42
- HTML全文浏览量: 14
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2024-01-12
- 修回日期: 2024-08-17
- 网络出版日期: 2024-12-11
- 刊出日期: 2024-10-10

The relationship between physical activity and cognitive function among the middle-aged and older adults in China: the moderating effect of diet

1.
Department of Sports Science, College of Education, Zhejiang University, Hangzhou 310058, China
2.
Laboratory for Digital Sports and Health, College of Education, Zhejiang University, Hangzhou 310058, China

More Information

Corresponding author: HU Liang, E-mail: lianghu@zju.edu.cn

摘要

摘要: 目的研究中老年人体力活动和认知功能关系，以及膳食健康水平对其关系的影响，为开展综合行为干预提供依据。方法基于中国健康与营养调查(China health and nutrition survey, CHNS)数据，纳入3 584名基线年龄≥55岁的研究对象，使用线性混合效应模型分析体力活动水平与认知功能的关联性，使用分层分析探讨不同膳食健康水平组中该关联性是否存在差异。结果校正人口学因素、生活方式因素和慢性病情况后，总体体力活动水平与整体认知功能得分差异有统计学意义(β=0.050, 95% CI: 0.035~0.065)；分层分析发现，在膳食健康水平较低的组中，总体体力活动水平与整体认知功能得分关联程度更强(β=0.094, 95% CI: 0.054~0.133)。结论对于中国中老年人群，特别是膳食健康水平较低的人群，需要更加关注通过加强体力活动来保护认知功能。
- 体力活动 /
- 膳食 /
- 认知功能 /
- 调节作用
Abstract: Objective To investigate the relationship between physical activity and cognitive function among the middle-aged and older adults in China, as well as the impact of diet on this relationship. The findings will provide a basis for implementing comprehensive behavioral interventions. Methods Based on the China health and nutrition survey (CHNS), 3 584 subjects with a baseline age of 55 years and above were included. A linear mixed-effects model was used to examine the association between physical activity and cognitive function, and a stratified analysis was conducted to determine whether such association varies between different groups of diet. Results After adjusting for demographic factors, lifestyle factors, and chronic disease conditions, there was a significant association between overall physical activity and total cognitive function scores (β=0.050, 95% CI: 0.035-0.065). Stratified analyses showed that in the group with lower health level of diet, the overall level of physical activity was more strongly associated with the total cognitive function score (β=0.094, 95% CI: 0.054-0.133). Conclusions More attention should be paid to protecting cognitive function by increasing physical activity level for middle-aged and elderly Chinese, especially those with low dietary health level.
- Physical activity /
- Diet /
- Cognitive function /
- Moderating effect

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表 1 不同体力活动水平组人群的人口学特征分布情况

Table 1. Demographic characteristics distribution of populations with different levels of physical activity

变量Variable	总人群Total population	体力活动水平Physical activity level			F/χ²值value	P值value
变量Variable	总人群Total population	低Low	中Medium	高High	F/χ²值value	P值value
样本量Sample size	3 584	971	1 271	1 342
年龄/岁Age/years ^①	62.32±6.88	63.94±7.60	62.82±6.89	60.68±5.90	71.251	< 0.001
性别Gender					23.573	< 0.001
女Female	1 908(53.2)	518(53.3)	738(58.1)	652(48.6)
男Male	1 676(46.8)	453(46.7)	533(41.9)	690(51.4)
居住地Residence					181.43	< 0.001
农村Rural	2 069(57.7)	556(57.3)	566(44.5)	947(70.6)
城市Urban	1 515(42.3)	415(42.7)	705(55.5)	395(29.4)
地域Region					40.278	< 0.001
北方Northern	1 435(40.0)	451(46.4)	531(41.8)	453(33.8)
南方Southern	2 149(60.0)	520(53.6)	740(58.2)	889(66.2)
受教育程度Education					15.154	0.004
文盲Illiteracy	1 548(43.2)	417(42.9)	528(41.5)	603(44.9)
小学Primary school	937(26.1)	249(25.6)	312(24.5)	376(28.0)
初中及以上Middle school and above	1 099(30.7)	305(31.4)	431(33.9)	363(27.0)
人均家庭年收入/元Per capita annual household income/yuan					14.487	0.006
< 3 509	1 266(35.3)	353(36.4)	405(31.9)	508(37.9)
3 509~< 8 017	1 255(35.0)	319(32.9)	464(36.5)	472(35.2)
≥8 017	1 063(29.7)	299(30.8)	402(31.6)	362(27.0)
总能量Total energy/(kcal·d^-1) ^①	2 106.30±617.26	1 988.86±604.45	2 051.95±589.22	2 242.74±627.30	57.017	< 0.001
BMI/(kg·m^-2)					25.389	< 0.001
< 24	2 229(62.2)	604(62.2)	734(57.7)	891(66.4)
24~< 28	1 019(28.4)	288(29.7)	389(30.6)	342(25.5)
≥28	336(9.4)	79(8.1)	148(11.6)	109(8.1)
吸烟Smoking					16.254	< 0.001
否No	2 422(67.6)	652(67.1)	909(71.5)	861(64.2)
是Yes	1 162(32.4)	319(32.9)	362(28.5)	481(35.8)
饮酒Drinking					37.927	< 0.001
否No	2 426(67.7)	691(71.2)	910(71.6)	825(61.5)
是Yes	1 158(32.3)	280(28.8)	361(28.4)	517(38.5)
慢性病情况Chronic disease status					38.261	< 0.001
无No	2 920(81.5)	761(78.4)	996(78.4)	1 163(86.7)
有Yes	664(18.5)	210(21.6)	275(21.6)	179(13.3)
MIND膳食得分Scores of MIND diet ^①	8.37±0.62	8.35±0.61	8.33±0.62	8.43±0.63	9.067	< 0.001
MIND膳食得分分组/分Score grouping of MIND diet/points					14.631	0.006
低Low (< 8)	575(16.0)	154(15.9)	229(18.0)	192(14.3)
中Medium (8~< 8.5)	992(27.7)	284(29.2)	364(28.7)	344(25.6)
高High(8.5~12)	2 017(56.3)	533(54.9)	678(53.3)	806(60.1)
整体认知功能得分Total cognitive function score ^①	15.94±4.88	15.17±4.97	16.24±4.96	16.22±4.68	16.842	< 0.001
回忆能力Recall ^①	10.33±3.99	9.83±4.02	10.48±4.10	10.55±3.82	10.736	< 0.001
计算能力Calculation ^①	3.83±1.67	3.60±1.77	3.96±1.62	3.88±1.62	14.139	< 0.001
注意力Attention ^①	1.78±0.52	1.75±0.57	1.80±0.50	1.79±0.50	2.863	0.057
注：MIND, 地中海-DASH干预神经退行性病变。 ①表示连续变量，其他为分类变量；连续变量使用x±s描述，分类变量使用人数(占比/%)描述；连续变量的组间比较采用单因素方差分析，分类变量组间比较采用χ²检验。 Note: MIND, Mediterranean-DASH intervention for neurodegenerative delay. ① Represents continuous variables, others are categorical variables; Continuous variables are described using x±s, while categorical variables are defined using number (percentage); The inter-group comparison of continuous variables is conducted using one-way analysis of variance, while the inter-group comparison of categorical variables is performed using chi-square test.

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表 2 体力活动水平和整体认知功能得分及各维度间的关联

Table 2. The association between physical activity levels and total cognitive function scores and various dimensions

变量 Variable	认知功能维度 Cognitive function dimensions	模型1 Model 1 β值value (95% CI)	模型2 Model 2 β值value (95% CI)	模型3 Model 3 β值value (95% CI)	模型4 Model 4 β值value (95% CI)
总体体力活动水平Overall physical activity level	整体认知功能得分Total cognitive function scores	0.074(0.058~0.089)^③	0.050(0.034~0.065) ^③	0.058(0.043~0.073) ^③	0.050(0.035~0.065) ^③
	回忆能力Recall	0.047(0.035~0.059) ^③	0.029(0.017~0.041) ^③	0.039(0.027~0.051) ^③	0.032(0.020~0.044) ^③
	注意力Attention	0.007(0.005~0.009) ^③	0.006(0.004~0.007) ^③	0.006(0.004~0.008) ^③	0.006(0.004~0.008) ^③
	计算能力Calculation	0.018(0.013~0.023) ^③	0.013(0.008~0.018) ^③	0.013(0.008~0.018) ^③	0.012(0.007~0.017) ^③
VPA	整体认知功能得分Total cognitive function scores	0.035(0.014~0.056)^②	-0.004(-0.025~0.017)	0.034(0.013~0.055) ^②	0.023(0.002~0.044) ^①
	回忆能力Recall	0.023(0.007~0.039) ^②	-0.005(-0.021~0.011)	0.026(0.009~0.042) ^②	0.017(0.000~0.034) ^①
	注意力Attention	0.003(0.000~0.005) ^①	0.000(-0.003~0.002)	0.004(0.001~0.006) ^②	0.003(0.001~0.006) ^①
	计算能力Calculation	0.008(0.001~0.015) ^①	-0.001(-0.008~0.006)	0.005(-0.002~0.012)	0.003(-0.004~0.010)
MPA	整体认知功能得分Total cognitive function scores	0.119(0.089~0.149) ^③	0.107(0.078~0.137) ^③	0.076(0.048~0.104) ^③	0.068(0.040~0.096) ^③
	回忆能力Recall	0.074(0.051~0.097) ^③	0.065(0.042~0.088) ^③	0.049(0.026~0.071) ^③	0.042(0.019~0.064) ^③
	注意力Attention	0.014(0.010~0.017) ^③	0.013(0.010~0.016) ^③	0.010(0.006~0.013) ^③	0.009(0.006~0.013) ^③
	计算能力Calculation	0.031(0.022~0.041) ^③	0.029(0.019~0.039) ^③	0.018(0.009~0.027) ^③	0.017(0.008~0.026) ^③
LPA	整体认知功能得分Total cognitive function scores	0.267(0.213~0.322) ^③	0.244(0.191~0.297) ^③	0.217(0.165~0.268) ^③	0.207(0.155~0.258) ^③
	回忆能力Recall	0.178(0.135~0.220) ^③	0.159(0.118~0.201) ^③	0.139(0.098~0.180) ^③	0.131(0.090~0.173) ^③
	注意力Attention	0.023(0.017~0.029) ^③	0.021(0.015~0.028) ^③	0.019(0.013~0.025) ^③	0.019(0.012~0.025) ^③
	计算能力Calculation	0.065(0.047~0.083) ^③	0.060(0.042~0.078) ^③	0.057(0.040~0.075) ^③	0.056(0.039~0.073) ^③
注：1. VPA，高强度体力活动；MPA，中等强度体力活动；LPA，低强度体力活动。 2. 模型1未进行调整；模型2调整了年龄、年龄的平方；模型3进一步调整了性别、居住地、地域、受教育程度和人均家庭年收入；模型4进一步调整了吸烟、饮酒、BMI、总能量和慢性病情况。 ① P < 0.05；② P < 0.01；③ P < 0.001。 Note: 1. VPA, vigorous-intensity physical activity; MPA, moderate-intensity physical activity; LPA, light-intensity physical activity. 2. Model 1 has not been adjusted; Model 2 adjusted age and the square of age; Model 3 further adjusted for gender, residence, region (northern/southern), education level, and per capita annual household income; Model 4 further adjusted for smoking, drinking, BMI, total energy, and chronic disease status. ① P < 0.05；② P < 0.01；③ P < 0.001.

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表 3 MIND膳食得分对体力活动水平与整体认知功能得分关联程度的影响

Table 3. The impact of MIND diet scores on the association between physical activity levels and total cognitive function scores

变量Variable	MIND膳食得分分组/分Scores grouping of MIND diet/points ^①			交互效应Interaction effect
变量Variable	低Low (< 8)	中Medium (8~< 8.5)	高High (8.5~12)	F值value	P值value
总体体力活动水平Overall physical activity level	0.094(0.054~0.133)	0.015(-0.014~0.044)	0.048(0.029~0.068)	6.723	0.001
VPA	0.077(0.016~0.138)	-0.015(-0.057~0.027)	0.022(-0.005~0.049)	4.691	0.009
MPA	0.109(0.039~0.180)	0.019(-0.036~0.074)	0.075(0.038~0.112)	2.607	0.074
LPA	0.281(0.155~0.407)	0.192(0.093~0.290)	0.177(0.107~0.246)	0.996	0.370
注：1. VPA，高强度体力活动；MPA，中等强度体力活动；LPA，低强度体力活动。 2. 模型调整了年龄、年龄的平方、性别、居住地、地域、受教育程度、人均家庭年收入、吸烟、饮酒、BMI、总能量和慢性病情况。 ①以β值(95% CI)表示。 Note: 1. VPA, vigorous-intensity physical activity; MPA, moderate-intensity physical activity; LPA, light-intensity physical activity. 2. Model adjusted age, the square of age, gender, residence, region, education level, per capita annual household income (low/medium/high), smoking, drinking, BMI, total energy, and chronic disease status. ① β value(95% CI).

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表 4 人口学因素、生活方式因素对体力活动水平与整体认知功能得分关联程度的影响

Table 4. The impact of demographic and lifestyle factors on the association between physical activity levels and total cognitive function scores

变量Variable	n(%)	β值value (95% CI)	F值value	P值value
年龄组/岁Age group/years			25.813	< 0.001
< 65	4 575(69.5)	0.029(0.011~0.046)
≥65	2 008(30.5)	0.119(0.088~0.150)
性别Gender			1.159	0.282
女性Female	3 674(55.8)	0.056(0.034~0.077)
男性Male	2 909(44.2)	0.042(0.021~0.063)
居住地Residence			6.220	0.013
农村Rural	3 830(58.2)	0.032(0.014~0.050)
城市Urban	2 753(41.8)	0.082(0.052~0.111)
地域Region			1.349	0.246
北方Northern	2 440(37.1)	0.061(0.035~0.088)
南方Southern	4 143(62.9)	0.046(0.027~0.065)
受教育程度Education			5.041	0.007
文盲Illiteracy	2 998(45.5)	0.066(0.042~0.090)
小学Primary school	1 654(25.1)	0.038(0.011~0.066)
初中及以上Middle school and above	1 931(29.3)	0.022(-0.006~0.049)
人均家庭年收入/元Per capita annual household income/yuan			0.664	0.515
< 3 509	2 194(33.3)	0.047(0.021~0.073)
3 509~< 8 017	2 193(33.3)	0.052(0.026~0.078)
≥8 017	2 196(33.4)	0.032(0.005~0.059)
BMI/(kg·m^-2)			5.228	0.005
< 24	4 088(62.1)	0.051(0.032~0.069)
24~< 28	1 882(28.6)	0.116(0.059~0.174)
≥28	613(9.3)	0.020(-0.009~0.050)
吸烟Smoking			0.005	0.945
否No	4 527(68.8)	0.053(0.034~0.072)
是Yes	2 056(31.2)	0.042(0.017~0.067)
饮酒Drinking			3.264	0.071
否No	4 638(70.5)	0.058(0.040~0.077)
是Yes	1 945(29.5)	0.031(0.006~0.057)
慢性病情况Chronic disease status			2.096	0.148
无No	5 216(79.2)	0.046(0.029~0.063)
有Yes	1 367(20.8)	0.066(0.029~0.104)
注：模型调整了年龄、年龄的平方、性别、居住地、地域、受教育程度、人均家庭年收入、吸烟、饮酒、BMI、总能量和慢性病情况，并排除分层分析对应的变量。 Note: Model adjusted age, the square of age, gender, residence, region, education level, per capita annual household income, smoking, drinking status, BMI, total energy, and chronic disease status, and excluded variables corresponding to stratified analysis.

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变量Variable	总人群Total population	体力活动水平Physical activity level			F/χ²值value	P值value
变量Variable	总人群Total population	低Low	中Medium	高High	F/χ²值value	P值value
样本量Sample size	3 584	971	1 271	1 342
年龄/岁Age/years ^①	62.32±6.88	63.94±7.60	62.82±6.89	60.68±5.90	71.251	< 0.001
性别Gender					23.573	< 0.001
女Female	1 908(53.2)	518(53.3)	738(58.1)	652(48.6)
男Male	1 676(46.8)	453(46.7)	533(41.9)	690(51.4)
居住地Residence					181.43	< 0.001
农村Rural	2 069(57.7)	556(57.3)	566(44.5)	947(70.6)
城市Urban	1 515(42.3)	415(42.7)	705(55.5)	395(29.4)
地域Region					40.278	< 0.001
北方Northern	1 435(40.0)	451(46.4)	531(41.8)	453(33.8)
南方Southern	2 149(60.0)	520(53.6)	740(58.2)	889(66.2)
受教育程度Education					15.154	0.004
文盲Illiteracy	1 548(43.2)	417(42.9)	528(41.5)	603(44.9)
小学Primary school	937(26.1)	249(25.6)	312(24.5)	376(28.0)
初中及以上Middle school and above	1 099(30.7)	305(31.4)	431(33.9)	363(27.0)
人均家庭年收入/元Per capita annual household income/yuan					14.487	0.006
< 3 509	1 266(35.3)	353(36.4)	405(31.9)	508(37.9)
3 509~< 8 017	1 255(35.0)	319(32.9)	464(36.5)	472(35.2)
≥8 017	1 063(29.7)	299(30.8)	402(31.6)	362(27.0)
总能量Total energy/(kcal·d^-1) ^①	2 106.30±617.26	1 988.86±604.45	2 051.95±589.22	2 242.74±627.30	57.017	< 0.001
BMI/(kg·m^-2)					25.389	< 0.001
< 24	2 229(62.2)	604(62.2)	734(57.7)	891(66.4)
24~< 28	1 019(28.4)	288(29.7)	389(30.6)	342(25.5)
≥28	336(9.4)	79(8.1)	148(11.6)	109(8.1)
吸烟Smoking					16.254	< 0.001
否No	2 422(67.6)	652(67.1)	909(71.5)	861(64.2)
是Yes	1 162(32.4)	319(32.9)	362(28.5)	481(35.8)
饮酒Drinking					37.927	< 0.001
否No	2 426(67.7)	691(71.2)	910(71.6)	825(61.5)
是Yes	1 158(32.3)	280(28.8)	361(28.4)	517(38.5)
慢性病情况Chronic disease status					38.261	< 0.001
无No	2 920(81.5)	761(78.4)	996(78.4)	1 163(86.7)
有Yes	664(18.5)	210(21.6)	275(21.6)	179(13.3)
MIND膳食得分Scores of MIND diet ^①	8.37±0.62	8.35±0.61	8.33±0.62	8.43±0.63	9.067	< 0.001
MIND膳食得分分组/分Score grouping of MIND diet/points					14.631	0.006
低Low (< 8)	575(16.0)	154(15.9)	229(18.0)	192(14.3)
中Medium (8~< 8.5)	992(27.7)	284(29.2)	364(28.7)	344(25.6)
高High(8.5~12)	2 017(56.3)	533(54.9)	678(53.3)	806(60.1)
整体认知功能得分Total cognitive function score ^①	15.94±4.88	15.17±4.97	16.24±4.96	16.22±4.68	16.842	< 0.001
回忆能力Recall ^①	10.33±3.99	9.83±4.02	10.48±4.10	10.55±3.82	10.736	< 0.001
计算能力Calculation ^①	3.83±1.67	3.60±1.77	3.96±1.62	3.88±1.62	14.139	< 0.001
注意力Attention ^①	1.78±0.52	1.75±0.57	1.80±0.50	1.79±0.50	2.863	0.057
注：MIND, 地中海-DASH干预神经退行性病变。 ①表示连续变量，其他为分类变量；连续变量使用x±s描述，分类变量使用人数(占比/%)描述；连续变量的组间比较采用单因素方差分析，分类变量组间比较采用χ²检验。 Note: MIND, Mediterranean-DASH intervention for neurodegenerative delay. ① Represents continuous variables, others are categorical variables; Continuous variables are described using x±s, while categorical variables are defined using number (percentage); The inter-group comparison of continuous variables is conducted using one-way analysis of variance, while the inter-group comparison of categorical variables is performed using chi-square test.

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中国中老年人群体力活动和认知功能的关系：膳食的调节作用

doi: 10.16462/j.cnki.zhjbkz.2024.10.004

通讯作者:
胡亮，E-mail：lianghu@zju.edu.cn

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The relationship between physical activity and cognitive function among the middle-aged and older adults in China: the moderating effect of diet

Corresponding author: HU Liang, E-mail: lianghu@zju.edu.cn

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中国中老年人群体力活动和认知功能的关系：膳食的调节作用

doi: 10.16462/j.cnki.zhjbkz.2024.10.004

通讯作者: 胡亮，E-mail：lianghu@zju.edu.cn

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The relationship between physical activity and cognitive function among the middle-aged and older adults in China: the moderating effect of diet

Corresponding author: HU Liang, E-mail: lianghu@zju.edu.cn

计量

出版历程

目录

通讯作者:
胡亮，E-mail：lianghu@zju.edu.cn