Effects of self-managed lifestyle behavioral changes on cognitive impairment control in Chinese older adults: a population-based prospective study.

IF 5.8 1区 医学 Q1 PSYCHIATRY
Jingjing Zhang, Dan Liu, Jing Liu, Cheng Cai, Feifei Hu, Guirong Cheng, Lang Xu, Yan Zeng
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Abstract

Few studies have examined the effects of self-managed lifestyle behavioral adjustment on cognitive status. This study aimed to explore the association between self-managed behavioral changes and transitions in cognitive status. The Hubei Memory and Aging Cohort Study was a prospective cohort study conducted from 2018-2023 in rural and urban areas. Home-dwelling adults aged ≥65 years completed neuropsychological, lifestyle, clinical, and cognitive assessments. The Cox regressions and cubic splines were used to assess the risk of incident cognitive impairment, and latent class analysis was used to group participants based on behavioral patterns and assess transitions in cognitive status. Among 2477 participants with a mean of 2.02 (SD, 1.25) years of follow-up were included in the study. Participants with low and intermediate compared with high baseline behavioral risk exhibited a reduced risk of incident cognitive impairment. At follow-up, those who maintained stable healthy behaviors or positively adjusted them had a 54% (HR, 0.46 [95% CI, 0.34-0.62]) and 84% (0.16 [0.07-0.35]) lower risk of developing cognitive impairment, respectively, compared with those who maintained unhealthy behaviors. The standard and reinforced behavioral adjustment patterns exhibited a 37% (0.63 [0.22-1.79]) and 77% (0.23 [0.05-0.97]) reduction in the risk of incident cognitive impairment, respectively, compared with the basic pattern. Optimal cognitive gains were attributed to positive adjustments in social networks, physical exercise, cognitive activity, and sleep health. Older adults who maintained healthy behaviors or positively adjusted their unhealthy behaviors exhibited a reduced risk of incident cognitive impairment. Positive behavior modification brought greater cognitive improvement to all participants and more pronounced effects for those with dementia.

自我管理生活方式行为改变对中国老年人认知障碍控制的影响:一项基于人群的前瞻性研究。
很少有研究考察自我管理的生活方式行为调整对认知状态的影响。本研究旨在探讨自我管理行为改变与认知状态转变之间的关系。湖北记忆与衰老队列研究是一项2018-2023年在农村和城市地区进行的前瞻性队列研究。年龄≥65岁的居家成年人完成了神经心理、生活方式、临床和认知评估。Cox回归和三次样条分析用于评估认知功能障碍的风险,潜在类别分析用于根据行为模式对参与者进行分组,并评估认知状态的转变。在2477名参与者中,平均随访时间为2.02 (SD, 1.25)年。与高基线行为风险的参与者相比,低和中等基线行为风险的参与者表现出发生认知障碍的风险降低。在随访中,与保持不健康行为的患者相比,保持稳定健康行为或积极调整健康行为的患者发生认知障碍的风险分别降低54% (HR, 0.46 [95% CI, 0.34-0.62])和84%(0.16[0.07-0.35])。与基本模式相比,标准行为调整模式和强化行为调整模式分别降低37%(0.63[0.22-1.79])和77%(0.23[0.05-0.97])发生认知障碍的风险。最佳的认知增益归因于社交网络、体育锻炼、认知活动和睡眠健康的积极调整。保持健康行为或积极调整不健康行为的老年人发生认知障碍的风险降低。积极的行为改变给所有参与者带来了更大的认知改善,对痴呆症患者的影响更明显。
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来源期刊
CiteScore
11.50
自引率
2.90%
发文量
484
审稿时长
23 weeks
期刊介绍: Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.
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