50岁及以上人群握力水平对认知功能影响的前瞻性队列研究  

A prospective cohort study on the association between grip strength and cognitive function in adults aged 50 years and above

作　　者：阮晔[1] 郭雁飞[2] 孙双圆 黄哲宙[1] 董俣君 施燕[1] 吴凡 Ruan Ye;Guo Yanfei;Sun Shuangyuan;Huang Zhezhou;Dong Yujun;Shi Yan;Wu Fan(Division of Chronic Non-communicable Disease and Injury,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;Shanghai Institutes of Preventive Medicine,Shanghai 200336,China;Office for Shanghai Medical College,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市疾病预防控制中心慢性非传染病与伤害防治所,上海200336 [2]上海市预防医学研究院,上海200336 [3]复旦大学上海医学院办公室,上海200032

出　　处：《中华流行病学杂志》2022年第10期1611-1618,共8页Chinese Journal of Epidemiology

基　　金：美国国立老龄研究所(R01-AG034479);上海市卫生健康委员会课题(201840118);上海市医学领军人才(2019LJ24);上海市加强公共卫生体系建设三年行动计划(2020-2022年)(GWV-10.1-XK16)。

摘　　要：目的探讨≥50岁人群握力水平对认知功能及其变化的影响。方法数据来源于WHO“全球老龄化与成人健康研究”(SAGE)上海现场基线及两次随访调查,对其中参加全部3轮调查、排除自报脑卒中或抑郁症患者后共计3600人进行分析,评估基线时不同水平的握力状况对认知功能及其变化的影响。认知功能通过评估词语回忆、语言流畅度及数字跨度测试结果,并采用因子分析方法进行综合,得到认知功能总分。使用线性混合效应模型分析基线握力水平对认知功能变化的影响。结果研究对象中男性1668人(46.3%),女性1932人(53.7%),基线年龄为(61.2±8.1)岁、握力为(28.19±12.18)kg、认知功能得分为58.93±14.56。研究对象认知功能得分在随访中呈下降趋势,且不同年龄组、文化程度和家庭经济水平者,其认知功能得分随时间下降幅度不同。在调整年龄、文化程度、婚姻状况、家庭经济水平、慢性病共患情况、吸烟、饮酒、体力活动、蔬菜水果摄入和BMI等后,未发现基线握力水平与基线及第一次随访认知功能相关,但与基线握力较低者相比,握力水平较高的调查对象,其第二次随访认知功能较好,且其认知功能的下降速度较慢(男性:β=1.938,95%CI:0.644~3.231,P=0.003;女性:β=2.192,95%CI:0.975~3.409,P<0.001;50~64岁:β=1.652,95%CI:0.646~2.659,P=0.001)。结论较高的握力水平,能减缓认知功能的衰退,可作为中老年人认知状况的预测因素。Objective To evaluate the association between grip strength(GS)and cognitive function in a population-based longitudinal cohort of Chinese adults aged≥50 years.Methods The study population of 3600 adults was from the baseline survey and two rounds of follow up of World Health Organization(WHO)study of global ageing and adult health(SAGE)in five districts of Shanghai(Hongkou,Huangpu,Minhang,Qingpu and Pudong)after excluding individuals with self-report stroke and depression.The effects of baseline GS on cognitive function and its changes were evaluated.Factor analysis was applied to generate an overall cognition score based on verbal recall trials,verbal fluency test,forward digit span test and backward digit span test.Linear mixed effects model was used to examine the predictive capability of baseline GS for changes in cognitive function.Results A total of 3600 participants aged(61.2±8.1)years at baseline survey were included in this study,including 1668(46.3%)men and 1932(53.7%)women.The average of baseline GS and total cognitive function score were(28.19±12.18)kg and(58.93±14.56)respectively.Cognitive function score declined significantly during the follow-up,however,the changes were different among different age groups,education level groups and household income groups.After adjusted for age,education level,marital status,household income,co-morbidity of chronic conditions,drinking status,smoking status,physical activity level,vegetable/fruit intakes and BMI,no relationships between the baseline GS and cognitive score at baseline survey and at 1st follow-up were observed,however,compared with lower GS quartile group,there was a significant relationship between higher baseline GS level and better cognitive function at 2nd follow-up.The participants with highest GS quartile had better cognitive performance over time(male:β=1.938,95%CI:0.644-3.231,P=0.003,female:β=2.192,95%CI:0.975-3.409,P<0.001 and those aged 50-64 years:β=1.652,95%CI:0.646-2.659,P=0.001)than those with the lowest quartile.Conclusions Hi

关 键 词：握力 认知 中老年人 前瞻性队列研究 

分 类 号：R749.1[医药卫生—神经病学与精神病学]