Associations between residence and cognitive function among Chinese older adults: the mediating role of leisure activity

Background:Cognitive function is a current research hotspot,residence may be related to differences in cognitive function,and the mediating role of leisure activities are limited in Chinese research.This study used leisure activities as a mediating variable to investigate the mediating role of leisure activity between place of residence(city-town-rural)and cognitive function among Chinese older,this is where the innovation of the article comes in.Methods:Using cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey,Pearson correlation analyses were employed to examine the relationships among various indicators.Mediation analyses were conducted using the SPSS PROCESS macro program,version 3.5,written by Hayes,to explore the mediating effects of leisure activity between place of residence and cognitive function in older adults.Results:A total of 10955 older adults were included in this study,with a mean age of(84.23±11.57)years.Among them,2739(24.8%)lived in the city,3627(33.1%)in town,and 4615(42.1%)in rural areas;their leisure activity score was(5.34±3.77),and their cognitive function score was(24.69±6.65).Place of residence,leisure activities,and cognitive function were significantly correlated(P<0.01).Using city as a reference,place of residence is negatively associated with cognitive function,and place of residence not only had a direct effect on cognitive function in older adults:town-cognitive function(effect=–0.399;95%confidence interval(CI)=(–0.685,–0.113));rural-cognitive function(effect=–0.42;95%CI=(–0.698,–0.141)).There were also indirect effects on cognitive function through the pathway of leisure activity:town-leisure activity-cognitive function(effect=–0.17;95%CI=(–0.246,–0.1)),rural-leisure activity-cognitive function(effect=–0.199;95%CI=(–0.272,–0.13)).Conclusion:Leisure activities play a partially mediating role between the impact of place of residence and cognitive function in Chinese older adults,and it is vital to pay attention to the impact of place of residence on the cognitive function of older adults in various aspects,and to increase the participation rate of older adults in leisure activities,which is beneficial to the prevention of cognitive decline and the protection of older adult’s physical and mental health.

The Association between Activity of Daily Living and the Combination of Alzheimer’s Disease and Cataract in Elderly Requiring Nursing Care

Some clinical and epidemiological studies have suggested that Alzheimer’s Disease (AD) and cataract, may share common pathogenetic mechanisms, subsequently a positive association between the prevalence of AD and cataract, although other studies found no significant relationship between dementia and visual impairment including cataract in the elderly. Little is known about the association between Activity of Daily Living (ADL) and the combination of AD and cataract. To examine the association between ADL and the combination of AD and cataract, we performed a national survey in nursing care institutions in Japan, examining the decreased ADL in elderly with and without AD and cataract for 453 elderly aged 85.0 ± 8.13 years. The proportion, 43.5% of AD in subjects without cataract was significantly higher than that, 23.5% with cataract. Almost all ADL in AD with cataract was significantly lower than that without cataract, although all ADL in cataract patients receiving surgery in AD was significantly (all p < 0.002) higher than that in cataract patients without surgery in AD, as was confirmed by the multiple regression analysis incorporating into the relevant factors as independent variables. These results showed that ADL scores including cognitive functions decreased by cataract were increased by the surgery in the patients with AD. A significantly negative association between AD and cataract seen in our data, which was inconsistent with the previous result, might lead to the necessities of the clinical diagnosis for slight severity of cataract for patients with AD.

Low Frequency of Leisure-Time Activities Correlates with Cognitive Decline and Apathy in Patients with Parkinson’s Disease

Objective: The purpose of this study is to investigate habitual leisure-time activities (physical and non-physical leisure activities) in patients with Parkinson’s disease (PD), and to determine any potential benefits of these activities on cognitive functions and emotional symptoms. Methods: Thirty-two patients with PD and 25 demographically-matched healthy controls participated in the present study. Neuropsychological tests (Wisconsin Card Sorting Test, Trail Making Test, Digit Span Test, Verbal Fluency Test, and Japanese Verbal Learning Test), assessment of emotional sym- ptoms, and interviews for confirmation of habitual leisure-time activities were conducted for all participants. Results: Patients with PD significantly showed the lower frequency of both physical and non-physical leisure activities than healthy controls. Compared to patients who engaged in physical leisure activities, patients who did not engage in such activities performed worse on the Trail Making Test (TMT-B, and TMT-B minus A). Moreover, patients who engaged in non-physical leisure activities were less apathetic than patients who did not engage in such activities. Conclusions: Our preliminary study shows that habitual leisure-time activities correlate with cognitive function and emotions in patients with PD. Reducing sedentary lifestyles and promoting habitual leisure-time activities may be helpful for preventing cognitive decline and apathy.

休闲活动对我国老年人认知功能的影响

本文通过分析中国老年健康影响因素跟踪调查(CLHLS)2011年的数据,研究了参与休闲活动对老年人认知功能的影响。研究发现,参与各项休闲活动比例较高的老年人,其认知功能缺损的比例相对较低。回归分析结果表明,当控制了样本的人口特征(包括年龄、受教育程度、性别、居住地)、社会经济地位、健康状况、以及生活习惯等变量以后,参与社交类、益智类、以及轻度户外活动的程度越高,我国老年人认知功能缺损的可能性就越低。这些发现鼓励我国老年人在晚年积极参与上述几类休闲活动从而降低其认知功能衰退的风险。

养老机构老年人睡眠质量对日常生活活动能力变化轨迹的预测

目的 探讨养老机构老年人日常生活活动能力变化的异质性轨迹,并分析睡眠质量对日常生活活动能力轨迹的预测作用,为制定提高日常生活活动能力的干预措施提供参考.方法 采用简易精神状态评价量表(MMSE)、Barthel指数评定表、阿森斯失眠量表对济南市5个区26家养老机构的296名老年人进行基线调查,追踪调查老年人1年内日常生活活动能力的变化,每6个月调查1次,共调查3次.结果 3次分别有296、244、203人完成调查.日常生活活动能力得分依次为78.62±25.90、74.31±27.78及74.11±27.81;对完成2次调查的250人拟合出日常生活活动能力高维持、中下降、低维持3条轨迹;Logistic回归分析示,睡眠质量、简易精神状态评价量表评分、年龄是日常生活活动能力轨迹的预测因素(P<0.05,P<0.01).结论 睡眠质量可以预测养老机构老年人的日常生活活动能力轨迹,老年人睡眠质量越差,日常生活活动能力轨迹越偏向于“低维持”.应为养老机构老年人制定可行的干预措施以改善其睡眠质量,从而提高其日常生活活动能力.

肺癌患者认知功能的现状及影响因素分析

目的 调查肺癌患者认知功能的现状及影响因素,为识别和管理癌症相关认知障碍提供主客观依据。方法 便利选取2021年10月—2022年8月收治于某院的390例肺癌患者作为研究对象。采用一般资料调查表、癌症治疗功能评估-认知功能量表、安德森症状评估量表、营养风险评分表等进行调查。将肺癌患者认知功能得分进行基于秩次的逆正态变换后,采用多元线性回归探索其影响因素。结果 390例肺癌患者的认知功能得分为121.00(107.00,126.00)分。年龄、性别、精神情绪症状群、确诊时间、休闲活动、营养风险评分进入回归方程(P<0.05),共解释总变异的42.4%。结论 本研究中肺癌患者自我报告的认知功能较好。精神情绪症状群、确诊时间、营养风险、休闲活动、年龄、性别是主要的影响因素。医护人员应重点评估以上因素,及时管理肺癌患者的认知功能,从而提升其生活质量。

富含维生素D食物及户外活动与认知功能关系

目的探索在中国饮食模式和户外活动方式下,维生素D与人群认知功能的关系。方法2017年6-9月在辽宁省4个城市抽取1115名≥60岁老年人,通过简易智力状态检查量表(MMSE)进行认知功能筛查,同时收集过去富含维生素D食物摄入习惯和户外活动行为等信息。使用聚类分析分别将人群富含维生素D食物摄入习惯和户外活动行为分为低、中、高3组,分析其与人群认知功能的关系。结果低维生素D组人群MMSE评分[(25.7±3.3)分]低于中、高维生素D组[分别为(26.1±3.3和26.4±2.9)分](F=4.42,P<0.05),低户外活动组人群MMSE评分[(25.4±3.2)分]低于中、高户外活动组[分别为(26.5±3.2和26.4±3.0)分](F=17.08,P<0.01)。控制年龄、教育程度等认知功能的其他影响因素后,富含维生素D食物摄入、户外活动的单独效应仍然存在,高维生素D食物摄入是认知功能的保护因素(OR=0.62,95%CI=0.46~0.83),高户外活动也是认知功能的保护因素(OR=0.69,95%CI=0.49~0.98)。结论多摄入富含维生素D食物和增加有效日光暴露的户外活动有利于预防老年人认知功能受损。

阿尔茨海默病早期相关保护性因素研究

目的 通过探讨阿尔茨海默病早期轻度认知功能损害的影响因素,为阿尔茨海默病认知障碍预防提供指导。方法 2021年1月—2022年1月选取湖州市5个社区的老年人为研究对象,其中300例轻度认知障碍(mild cognitive impairment, MCI)老年人作为研究组,另选择300例正常老年人群作为对照组。评价患者的认知活动评分(CAS)、教育与社会经济地位(SES)、抑郁自评量表得分(SDS)、神经心理测试,分析相关因素对认知功能缺陷的影响和保护作用。结果 MCI患者的MMSE评分(25.0±1.4)分显著低于对照组(28.9±1.1)分;SDS评分(35.5±4.5)分明显高于对照组(32.0±4.6)分,差异均有统计学意义(均P<0.05)。组间在平均受教育年限、CAS和SES方面比较,差异均有统计学意义(均P<0.05)。经logistic多元回归分析,结果显示,学历高、CAS分级高和SES分级高是影响阿尔茨海默病发生的保护因素(均P<0.05)。结论 社区老年患者中较高水平的认知活动与社会经济地位以及高水平的教育是阿尔茨海默病痴呆风险的保护性因素。

业余活动与60岁以上老年人认知功能的关系

目的探讨业余活动与60岁以上老年人认知功能的关系。方法采用多阶段整群随机抽样方法调查石家庄市社区1203例60岁以上老年人，根据业余活动量分为高业余活动（n=504）和低业余活动（n=699）组，两组受试者性别、年龄和受教育年限相匹配，差异无统计学意义（P均〉0．05）。采用简易智力状况检查（Mini—Mental State Examination，MMSE）和蒙特利尔认知评估（Montreal Cog—nitive Assessment，MoCA）评价两组受试者的认知功能状况。结果（1）在1203例老年人中，MMSE筛查阳性率（低于划界值）19．5％（234例），MoCA筛查阳性率（低于划界值）66．9％（805例），MoCA的阳性检出率高于MMSE，差异有统计学意义（P=0．000）；（2）按照MMSE和MoCA划界分，高业余活动组与低业余活动组MMSE筛查阳性率的差异无统计学意义（P=0．162），高业余活动组MoCA筛查阳性率高于低业余活动组，差异有统计学意义（P=0．012）；（3）高业余活动组与低业余活动组的MMSE总分差异无统计学意义（P=0．061），高业余活动组MoCA总分高于低业余活动组，差异有统计学意义（P=0．011）；（4）高业余活动组注意力和计算力、语言及延迟回忆得分高于低业余活动组，差异有统计学意义（P均〈0．05）。结论60岁以上高业余活动老年人认知功能损害发生率较低。

老年休闲活动参与及其对认知功能影响研究

目的调查老年休闲活动参与和认知功能的现状，并分析休闲活动对认知功能的影响。方法采用一般资料调查表、蒙特利尔认知评估量表、休闲活动调查问卷，对528名社区老年人进行调查。结果娱乐活动和智力活动参与的老年人认知功能评分分别为（25.65 ± 2.58）、（25.76 ± 2.48）分，高于未参与者的（25.21 ± 2.53）、（25.58 ± 2.60）分，差异有统计学意义（Z=5.56、8.16，P〈0.01）；体力活动和社交活动参与与否老年人认知功能评分比较差异无统计学意义（P〉0.05）。智力、娱乐活动的参与与认知功能呈正相关（r=0.347、0.270，P〈0.01），而社交活动、体力活动与认知功能不具有相关性（P〉0.05）。 结论积极参与休闲活动对改善老年人认知功能有重要意义，建议积极加强对社区老年人的活动指导和干预，进而改善老年人的认知功能。