全球精选文摘 - 身体锻炼、认知功能及死亡率的一项美国全国性队列研究

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身体锻炼、认知功能及死亡率的一项美国全国性队列研究

Physical Activity, Cognitive Function, and Mortality in a US National Cohort

Gillum RF, Obisesan TO 2010/7/30 15:42:55

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Ann Epidemiol , 2010,

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Purpose:
Increasing physical activity is postulated to slow cognitive decline associated with aging. Low levels of both physical activity and cognitive function are associated with increased risk of mortality. We test the hypothesis that the relative protective effect of high physical activity level as related to mortality is greater in persons with impaired cognitive function than in others.

Methods:
Data were analyzed from a longitudinal mortality follow-up study of 5903 American men and women aged 60 years and older examined in 1988 to 1994 who were followed an average of 8.5 years. Measurements at baseline included self-reported leisure-time physical activity (LTPA), a short index of cognitive function (SICF), sociodemographic data, health status, and physical and biochemical measurements.

Results:
Death during follow-up occurred in 2431 persons. In bivariate cross-sectional analyses, more frequent LTPA was associated with greater cognitive function. In proportional hazards regression analysis, no significant interaction of LTPA with cognitive function was found; however, there was a significant age- LTPA interaction. After adjusting for confounding by baseline sociodemographic data and health status at ages 60 to 74, the hazards ratio (95% confidence intervals) was for LTPA more than 8 times weekly compared with none (0.51; 0.38–0.76, p<.001) and for low SICF score compared with high 1.43 (1.36; 1.00–1.84, p<.05). After controlling for health behaviors, blood pressure, and body mass, C-reactive protein, and high-density lipoprotein cholesterol, the LTPA hazards ratio was 0.52 (0.35–0.78; p=.002), but cognitive function was no longer significant. At ages 75 and older, results were similar for LTPA, but cognitive function remained significant after adjustment.

Conclusions:
In a nationwide cohort of older Americans, analyses demonstrated a lower risk of death independent of confounders among those with frequent LTPA. Much of the effect of low cognitive function could be explained by other risk factors at ages 60 to 74 but not 75 years and older.

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高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
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冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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