老年高血压患者身体活动能力对认知功能的影响

目的探讨老年高血压患者身体活动能力对认知功能的影响。方法 2015年8月至2016年5月从武汉市28个社区卫生服务中心/乡镇卫生院分层随机抽取年龄≥65岁的高血压患者1 508人,患者的身体活动状况采用老年人身体活动量表(PASE)评估,其中身体活动包括休闲身体活动、家务活动、职业身体活动;认知功能采用简易精神状态量表(MMSE)评估。结果多因素非条件Logistic回归分析结果显示,较多身体活动、受教育程度高、运动习惯好是认知功能的保护性因素,而高龄是认知功能的危险因素;认知功能与性别有关,女性较男性认知功能差;认知功能与高血压患者吸烟、体质量指数、腰围身高比、血压水平分级、高血压合并糖尿病、冠心病、高血脂症未见显著相关性(P>0.05);多元线性回归分析结果显示,将身体活动细化分类后,认知功能与休闲身体活动中坐着的运动、外出散步或步行、中度身体活动、费力身体活动以及职业身体活动呈正相关,且与坐着的运动、外出散步或步行相关性最明显(β值分别为0.185,0.191;均P<0.05)。认知功能与轻度身体活动、增加肌肉力量的活动、家务活动不相关(P>0.05)。结论老年高血压患者较多身体活动是认知功能的保护性因素,认知功能与休闲身体活动中坐着的运动、外出散步或步行相关性最明显。

Effects of physical activity ability on cognitive function in elderly patients with hypertension

Objective To investigate the effects of physical activity ability on cognitive function in elderly patients with hypertension. Methods From August 2015 to May 2016, a total of 1 508 elderly hypertension patients were randomly selected from 28 community health service centers/township health centers in Wuhan city. Physical activity scale for the elderly(PASE) was used to assess the physical activity, including leisure physical activity, household activity and occupational physical activity. The mini-mental state examination(MMSE) was used to assess the cognitive function of patients. Results Multivariate unconditioned Logistic regression analysis showed that more physical activity, high education level and good exercise habit were protective factors for cognitive function, while age and waist-to-height ratio were risk factors for cognitive function. Cognitive function was related to gender, which was worse in female than in male. No significant correlation was found between cognitive function and smoking, body mass index, grade of blood pressure, hypertension combined with diabetes, coronary heart disease and hyperlipidemia(P>0.05). After detailed classification of physical activity, multivariate linear regression analysis showed that cognitive function was positively correlated with sitting exercise, walking or going out, moderate physical activity, strenuous physical activity, and occupational physical activity. The correlation between cognitive function and sitting exercise, walking or going out was the most obvious(β=0.185, 0.191;all P<0.05). Cognitive function was not correlated with mild physical activity, activities to increase muscle strength and housework activities(P>0.05). Conclusion More physical activity is a protective factor for cognitive function in elderly patients with hypertension. The correlation is the most obvious between cognitive level and sitting exercise, walking or going out.