基于倾向性评分匹配的老年运动与认知功能关联病例对照研究  

A case-control study on the association between exercise and cognitive function in elderly individuals based on propensity score matching

作　　者：蔡欢乐 冯梦 王奕婧 孙诺敏 余灿清[3,4,5] 马起山 刘刚[2] 李晓恒[2] 顾菁[1] 郝元涛[4,5] CAI Huanle;FENG Meng;WANG Yijing;SUN Nuomin;YU Canqing;MA Qishan;LIU Gang;LI Xiaoheng;GU Jing;HAO Yuantao(School of Public Health,Sun Yat-sen University,Guangzhou,Guangdong 510080,China;不详)

机构地区：[1]中山大学公共卫生学院,广东广州利510080 [2]深圳市疾病预防控制中心 [3]北京大学公共卫生学院 [4]北京大学公众健康与重大疫情防控战略研究中心 [5]重大疾病流行病学教育部重点实验室(北京大学)

出　　处：《中国预防医学杂志》2025年第3期347-352,共6页Chinese Preventive Medicine

基　　金：深圳市“医疗卫生三名工程”项目(SZSM202311001)。

摘　　要：目的了解深圳市≥65岁老年人运动对认知功能初筛障碍的影响,为老年人认知功能障碍防治提供最佳运动方式建议。方法基于深圳市国家基本公共卫生服务项目,采用基于倾向性评分匹配的1∶1病例对照研究设计,将2022年老年人管理项目中认知功能障碍初筛阳性的12730名老年人作为病例组,采用最邻近匹配法匹配12730名认知功能障碍初筛阴性的老年人作为对照组。由培训合格的全科医生对老年人认知功能和运动情况进行问卷评估。采用多因素logistic回归分析运动对老年人认知功能的影响,限制性立方样条分析运动与认知功能的剂量反应关系曲线。结果深圳市≥65岁老年人认知功能初筛障碍的人群中,每天运动的比例为65.89%,从不运动的比例为23.00%;而对照组每天运动的比例71.85%,从不运动的比例16.64%,两组差异有统计学意义(χ^(2)=180.16,P<0.001)。多因素logistic回归结果显示,相较于从不运动的人,偶尔运动者认知功能障碍风险的OR值为0.84(95%CI:0.74~0.95),每周运动≥1次者OR值为0.61(95%CI:0.55~0.69),每天运动者OR值为0.66(95%CI:0.62~0.70)。限制性立方样条回归结果显示,每次运动时长对老年认知功能障碍的效应均呈现为“U”型曲线,每次运动时长约50 min对认知功能的保护效应最大。坚持运动年数呈现为“L”型曲线,即相较于从不运动,坚持长期运动对老年人认知功能保护效应稳定。结论运动对≥65岁老年人认知功能具有保护作用,建议采取每周运动≥1次,每次运动约50 min,并长期坚持运动,对认知功能的保护作用最佳。Objective To investigate the impact of exercise on cognitive function screening among elderly individuals(aged 65 and above)in Shenzhen,and to provide recommendations for optimal exercise interventions to prevent and manage cognitive impairment.Methods Utilizing data from the National Basic Public Health Service Project in Shenzhen,a 1∶1 case-control study design based on propensity score matching was employed.The study included 12730 elderly individuals with positive initial cognitive impairment screenings as the case group,matched with 12730 controls who had negative screening results using the nearest neighbor matching method.Trained general practitioners conducted questionnaire assessments of cognitive function and exercise habits.Multivariate logistic regression analysis was used to analyze the relationship between exercise and cognitive,and restricted cubic spline regression was employed to examine the dose-response relationship between exercise and cognitive function.Results Among older adults with cognitive impairment screening in Shenzhen,the proportion of individuals exercising daily was 65.89%,while 23.00%reported no exercise.In contrast,the control group had a daily exercise rate of 71.85%and a non-exercise rate of 16.64%,with significant differences between the two groups(χ^(2)=180.16,P<0.001).Multivariate logistic regression showed that compared to nonexercisers,the odds ratio(OR)for cognitive impairment risk was 0.84(95%CI:0.74-0.95)for occasional exercisers,0.61(95%CI:0.55-0.69)for those exercising at least once a week,and 0.66(95%CI:0.62-0.70)for daily exercisers.The restricted cubic spline regression showed a"U"-shaped curve for the effect of exercise duration on cognitive impairment,with approximately 50 minutes of exercise per session providing the greatest protective effect.The number of years of consistent exercise showed an"L"-shaped curve,indicating that long-term adherence to exercise offers stable protective effects on cognitive function compared to non-exercisers.Conclusions Exercise

关 键 词：认知障碍 老年人 运动 倾向性评分匹配 

分 类 号：R749.16[医药卫生—神经病学与精神病学]