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Physical fitness and dementia risk in the very old: a study of the Lothian Birth Cohort 1921

机译:非常旧的身体健康和痴呆症风险:洛锡安出生队队1921年的研究

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摘要

Abstract Background Previous studies have demonstrated that individual measures of fitness – such as reduced pulmonary function, slow walking speed and weak handgrip – are associated with an increased risk of dementia. Only a minority of participants included in these studies were aged over 80. The aim of this study was therefore to investigate the association between physical fitness and dementia in the oldest old. Methods Subjects (n = 488) were enrolled in the Lothian Birth Cohort 1921 and aged 79 at baseline. Dementia cases arising after enrolment were determined using data from death certificates, electronic patient records and clinical reviews. Fitness measures included grip strength, forced expiratory volume in 1 s (FEV1) and walking speed over 6 m, measured at 79 years. Dementia risk associated with each fitness variable was initially determined by logistic regression analysis, followed by Cox regression analysis, where death was considered as a competing risk. APOE ε4 status, age, sex, height, childhood IQ, smoking, history of cardiovascular or cerebrovascular disease, hypertension and diabetes were included as additional variables. Cumulative incidence graphs were calculated using Aalen-Johansen Estimator. Results Although initial results indicated that greater FEV1 was associated with an increased risk of dementia (OR (odds ratio per unit increase) 1.93, p = 0.03, n = 416), taking into account the competing risk of mortality, none of the fitness measures were found to be associated with dementia; FEV1 (HR (hazard ratio per unit increase) 1.30, p = 0.37, n = 416), grip strength (HR 0.98, p = 0.35, n = 416), walking speed (HR 0.99, p = 0.90, n = 416). The presence of an APOE ɛ4 allele was however an important predictor for dementia (HR 2.85, p < 0.001, n = 416). Cumulative incidence graphs supported these findings, with an increased risk of dementia for APOE ɛ4 carriers compared with non-carriers. While increased FEV1 was associated with reduced risk of death, there was no reduction in risk for dementia. Conclusions In contrast to previous studies, this study found that lower fitness beyond age 79 was not a risk factor for subsequent dementia. This finding is not explained by those with poorer physical fitness, who would have been more likely to develop dementia, having died before onset of dementia symptoms.
机译:摘要背景技术已经证明了各个健身措施 - 例如降低肺功能,缓慢的步行速度和弱手柄 - 与痴呆症的风险增加有关。这些研究中只包含的少数参与者在80岁以上。因此,本研究的目的是调查最旧的身体健康和痴呆之间的关联。方法受试者(n = 488)在基线中注册了洛锡初生队1921年和年龄的79岁。使用死亡证明,电子患者记录和临床评论的数据确定入学后产生的痴呆症病例。健身措施包括握力,1 s(FEV1)的强制呼气量,步行速度超过6米,在79年内测量。与每个健身变量相关的痴呆风险最初通过逻辑回归分析确定,其次是COX回归分析,其中死亡被认为是竞争风险。 Apoeε4状态,年龄,性别,高度,儿童智商,吸烟,心血管或脑血管疾病,高血压和糖尿病的唯一变量。使用Aalen-Johansen估算器计算累积发射图。结果虽然初始结果表明,更大的FEV1与痴呆风险增加(或每单位的差率比)1.93,p = 0.03,n = 416),但考虑到死亡率的竞争风险,没有一个健身措施被发现与痴呆症有关; FEV1(HR(每单位危险比)1.30,P = 0.37,n = 416),握力(HR 0.98,P = 0.35,n = 416),步行速度(HR 0.99,P = 0.90,n = 416) 。然而,ApoEɛ4等位基因的存在是痴呆的重要预测因子(HR 2.85,P <0.001,n = 416)。累积发病率曲线图支持这些发现,其与非载体相比,Apoeɛ4载体的痴呆风险增加。虽然增加FEV1与降低死亡风险有关,但痴呆症的风险没有减少。结论与先前的研究相比,该研究发现,超过79岁以下的健身性不是随后痴呆的危险因素。这种发现不会被那些具有较差的身体健康的人解释,谁将更有可能发展痴呆症,在痴呆症状开始之前死亡。

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