老年人24小时活动行为与痴呆发病关系的纵向成分数据分析研究

Relationship between 24-hour movement behavior and incidence of dementia in the elderly:a longitudinal compositional data analysis study

中文关键词: 老年人  24h活动行为  痴呆  成分等时替代模型

英文关键词: elderly  24-hour movement behavior  dementia  compositional isotemporal substitution model

中文摘要:

      目的 探讨老年人24 h 活动行为(24-HM)与痴呆发病的关联,为制订生活方式干预策略提供依据.方法 选取2013 年2 月至2015 年12 月英国生物银行数据库中年龄≥60 岁且未患痴呆的49 955 名老年人的数据.采用加速度计收集研究对象24-HM 数据,以研究对象佩戴加速度计的时间作为基线,并进行平均(9.51±1.45)年的随访,从英国国家卫生信息系统中统计老年人的痴呆发病信息.采用成分 Cox 回归模型分析 24-HM 与痴呆发病的关联,并利用成分等时替代模型评估不同行为时间相互替换对风险的影响.结果 本研究随访时间内共确诊痴呆526 例,发病率为1.05%.成分 Cox 回归模型显示,中重度及轻度身体活动时间与痴呆风险呈负相关,久坐时间与风险呈正相关.成分等时替代模型显示,将30 min 的久坐、睡眠或轻度身体活动时间替换为中重度身体活动,痴呆发病风险分别降低 12%(95%CI:7%～16%)、7%(95%CI:2%～10%)和5%(95%CI:1%～10%).结论 老年人24 h 活动行为的时间分配与痴呆风险存在关联,增加中重度身体活动的时间可能有助于降低痴呆风险.

英文摘要:

      Objective To explore the relationship between 24-hour movement behaviors(24-HM)and incidence of dementia in the elderly,and provide evidence for developing lifestyle intervention strategies.Methods Data from 49 955 elderly individuals aged≥60 years without dementia were selected from the UK Biobank database from February 2013 to December 2015.Accelerometers were used to collect their 24-HM data.The time when the subjects wore the accelerometers was taken as the baseline,and an average follow-up of(9.51±1.45)years was conducted.The data on the incidence of dementia among the elderly was obtained from the National Health Information System of the United Kingdom.The compositional Cox regression model was used to analyze the association between 24-HM and the incidence of dementia,and the compositional isotemporal substitution model was used to evaluate the effect of mutual substitution of different behavioral times on the risk.Results During the follow-up period,526 cases of dementia were diagnosed,with an incidence of 1.05%.The compositional Cox regression model showed that time spent in moderate-to-vigorous and light physical activity was negatively associated with the risk of dementia,while sedentary time was positively associated with the risk of dementia.The compositional isotemporal substitution models showed that when 30 minutes of sedentary time,sleep or light physical activity was replaced with moderate-to-vigorous physical activity,the risk of dementia was reduced by 12%(95%CI:7%-16%),7%(95%CI:2%-10%)and 5%(95%CI:1%-10%),respectively.Conclusion The time allocation of 24-HM in the elderly is associated with the risk of dementia.Increasing time spent in moderate-to-vigorous physical activity may help reduce the risk of dementia.