脑力活动对老年人认知功能不同领域的影响研究

Effects of Intellectual Activities on Different Domains of Cognitive Function in Elderly People

背景老年人进行阅读、益智游戏等脑力活动可以减缓认知功能的衰退,但具体脑力活动类型对认知功能及各认知域的影响尚待进一步研究。目的探究社区老年人常见脑力活动类型对其认知功能及各认知域的影响。方法2022年5—8月采用分层便利采样法选取江苏省南京市、常州市、南通市、徐州市4地社区老年人为研究对象。采用一般资料调查表和蒙特利尔认知评估量表(MoCA)北京版对老年人社会学人口资料、脑力活动频次、脑力活动类型、认知功能进行面对面调查。采用多元线性逐步回归分析探究脑力活动与认知功能不同认知域的关系。结果共发放问卷782份,回收有效问卷758份,问卷有效回收率为96.93%。758例老年人中南京市123例、常州市197例、南通市240例、徐州市198例。社区老年人进行过脑力活动的情况:学习新知识170例、玩棋牌228例、阅读228例、唱歌59例、益智游戏57例、辅导孙辈功课42例、绘画16例、演奏乐器47例、练习书法30例。多元线性逐步回归分析结果显示,学习新知识、阅读、辅导孙辈功课、益智游戏、演奏乐器是老年人认知功能的影响因素(P<0.05)。学习新知识(B=0.250)、阅读(B=0.590)、益智游戏(B=0.585)、辅导孙辈功课(B=0.711)、演奏乐器(B=0.643)是老年人视空间与执行能力认知域的影响因素(P<0.05);学习新知识是老年人抽象(B=0.219)、延迟回忆/记忆(B=0.727)认知域的影响因素(P<0.05);阅读是老年人命名(B=0.095)、注意(B=0.207)、语言(B=0.290)、抽象(B=0.241)、延迟回忆/记忆(B=0.377)认知域的影响因素(P<0.05);益智游戏(B=0.290)、演奏乐器(B=0.278)是老年人语言认知域的影响因素(P<0.05)。其中,阅读共进入了7次回归方程,对MoCA总分的影响标准化回归系数为0.225,高于其他脑力活动类型。结论脑力活动如阅读、学习新知识、益智游戏、辅导孙辈功课和演奏乐器均可以维持或改善社区老年人的认知功能,不同类型的脑力活动对认知功能的影响存在领域特异性,这对老年人认知功能衰退的预防与干预有着积极意义。

Background Intellectual activities such as reading and playing puzzle games can slow the decline of cognitive function in the elderly,but the effects of specific types of such activities on cognitive function and cognitive domains need to be further studied.Objective To explore the influence of common types of intellectual activities on cognitive function and cognitive domains of the elderly in the community.Methods From May to August 2022,stratified convenience sampling was used to select elderly people from four communities in Nanjing,Changzhou,Nantong and Xuzhou of Jiangsu Province.A face-to-face survey was conducted with a general information questionnaire and the Montreal Cognitive Assessment(MoCA)Beijing edition to collect data regarding sociodemographics,frequency and types of intellectual activities,and cognitive function.Stepwise multiple regression analysis was used to explore the relationship between intellectual activities and different cognitive domains.Results In total,782 cases attended the survey,and 758 of them(96.93%)who completed it were included for analysis,including123 from Nanjing,197 from Changzhou,240 from Nantong,and 198 from Xuzhou.The intellectual activities done by these older people include learning new knowledge(n=170),playing chess and cards(n=228),reading(n=228),singing(n=59),playing puzzle games(n=57),helping grand children with their homework(n=42),painting(n=16),playing a musical instrument(n=47),and practicing calligraphy(n=30).Stepwise multiple linear regression analysis showed that learning new knowledge,reading,helping grand children with their homework,playing puzzle games and playing musical instruments were associated with cognitive function(P<0.05).Learning new knowledge(B=0.250),reading(B=0.590),playing puzzle games(B=0.585),helping grand children with their homework(B=0.711),and playing musical instruments(B=0.643)were the influencing factors of Visuospatial/Executive(P<0.05).Learning new knowledge(B=0.219)was an influencing factor of Abstraction and Delayed recall/Memory(B=0.727)(P<0.05).Reading was a factor affecting Naming(B=0.095),Attention(B=0.207),Language(B=0.290),Abstraction(B=0.241),and Delayed recall/Memory(B=0.377)(P<0.05).Playing puzzle games(B=0.290)and playing musical instruments(B=0.278)were the influencing factors of Language(P<0.05).Among various types of activities,reading was included in a total of seven regression equations,with a standardized regression coefficient of 0.225 for its impact on the total score of MoCA,which was higher than that of the other types.Conclusion Intellectual activities such as reading,learning new knowledge,playing puzzle games,helping grand children with their homework and playing a musical instrument can maintain or improve the cognitive function of the elderly in the community.The effects of different types of intellectual activities on cognitive function are domain-specific,which has a positive significance for the prevention and intervention of cognitive function decline of the elderly.