Association of dietary patterns with cognitive impairment among community elderly people in Taiyuan city
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摘要:
目的 了解山西省太原市社区老年人膳食模式及其与认知功能障碍的关系,为认知功能障碍的预防控制提供参考依据。 方法 于2016年6月 — 2017年7月采用分层整群随机抽样方法在太原市抽取565名 ≥ 65岁社区老年人进行问卷调查,采用因子分析和多因素logistic回归模型分析老年人膳食模式与其认知功能障碍的关系。 结果 太原市565名 ≥ 65岁社区老年人中,无认知功能障碍者335人(59.29%),有认知功能障碍者230例(40.71%);因子分析共得到植物类膳食模式、肉类膳食模式、水果蛋奶膳食模式和甜食膳食模式4种膳食模式,累计方差贡献率为51.84%;在调整了性别、年龄、文化程度、吸烟情况、饮酒情况、锻炼情况、是否高血压、是否糖尿病和是否高脂血症等混杂因素后,多因素非条件logistic回归分析结果显示,肉类模式得分是Q4者的认知功能障碍患病风险为得分是Q1者的0.570倍(OR = 0.570,95 % CI = 0.336~0.967),水果蛋奶模式得分是Q3和Q4者的认知功能障碍患病风险分别为得分是Q1者的0.847倍(OR = 0.847,95 % CI = 0.712~0.992)和0.527倍(OR = 0.527,95 % CI = 0.319~0.872)。 结论 食用较多的水果、蛋类、奶类和肉类可降低太原市社区老年人认知功能障碍的患病风险。 Abstract:Objective To explore the correlation between dietary patterns and cognitive impairment among elderly residents in communities of Taiyuan city, Shanxi province and to provide evidences for the prevention and control of cognitive dysfunction. Methods Using stratified cluster random sampling, we recruited 600 community residents aged 65 years and older in 6 districts of Taiyuan city for a survey conducted from June 2016 to July 2017. A self-designed questionnaire, Food Frequency Questionnaire and Mini-Mental State Examination were used to collect relevant information of the elderly. Dietary patterns of the elderly were discriminated with factor analysis and multivariate logistic regression analysis was adopted to assess associations of dietary patterns with cognitive impairment of the elderly. Results Of the 565 participants with valid information, 230 (40.71%) were identified having cognitive impairment. Factor analyses revealed four dietary patterns (namely patterns of plant, meat, fruit egg-milk, and sweet food) for the participants and the cumulative variance contribution rate of the four dietary patterns was 51.84%. After adjusting for gender, age, education, smoking, alcohol drinking, physical exercise, hypertension, diabetes, and hyperlipidemia, the results of unconditional multivariate logistic regression analysis demonstrated that compared to those with lower scores (in the lowest quartile, Q1) of meat and fruit egg-milk dietary patterns, the participants with higher scores (in the highest quartile [Q4] or in the higher quartile [Q3]) of the two dietary patterns were at a decreased risk of cognitive impairment (meat pattern score of Q4 vs. Q1: odds ratio [OR] = 0.570, 95% confidence interval [CI]: 0.336 – 0.967; fruit egg-milk pattern of Q3 vs. Q1: OR = 0.847, 95% CI: 0.712 – 0.992 and Q4 vs. Q1: OR = 0.527, 95% CI: 0.319 – 0.872). Conclusion Higher dietary intake of fruits, eggs, milk and meat are related to a decreased risk of cognitive impairment among community elderly residents in Taiyuan city. -
Key words:
- cognitive impairment /
- dietary pattern /
- relationship /
- community elderly
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表 1 太原市不同组别社区老年人一般特征比较
特征 认知功能障碍组(n = 230) 非认知功能障碍组(n = 335) χ2 值 P 值 例数 % 人数 % 性别 男性 86 37.4 140 41.8 1.10 0.294 女性 144 62.6 195 58.2 年龄(岁) 65~69 73 31.7 147 43.9 30.27 < 0.001 70~74 47 20.4 101 30.1 75~79 68 29.6 61 18.2 ≥ 80 42 18.3 26 7.8 文化程度 小学及以下 140 60.9 131 39.1 36.14 < 0.001 初中及以上 90 39.1 204 60.9 吸烟情况 不吸烟 163 70.9 270 80.6 7.21 0.007 吸烟 67 29.1 65 19.4 饮酒情况 不饮酒 195 84.9 277 82.7 0.44 0.509 饮酒 35 15.2 58 17.3 锻炼情况 不锻炼 73 31.7 97 29.0 0.50 0.478 锻炼 157 68.3 238 71.0 高血压 否 120 52.2 188 56.1 0.86 0.355 是 110 47.8 147 43.9 糖尿病 否 200 87.0 270 80.6 3.94 0.047 是 30 13.0 65 19.4 高脂血症 否 175 76.1 234 69.9 2.65 0.103 是 55 23.9 101 30.1 表 2 太原市社区老年人膳食模式的因子载荷矩阵
项目 植物类膳食模式 肉类膳食模式 水果蛋奶膳食模式 甜食膳食模式 食物分类 载荷 食物分类 载荷 食物分类 载荷 食物分类 载荷 谷类 0.660 畜肉类 0.650 水果 0.475 甜食 0.813 薯类 0.799 禽肉类 0.671 蛋类 0.500 蔬菜 0.715 鱼虾蟹贝类 0.591 奶类及制品 0.731 水果 0.543 腌制及油炸食品 0.450 坚果类 0.397 豆类及制品 0.443 特征根 3.17 1.39 1.12 1.06 方差贡献率(%) 24.37 10.69 8.63 8.15 累计方差贡献率(%) 24.37 35.06 43.69 51.84 表 3 太原市社区老年人膳食模式与认知功能障碍关系
膳食模式 调查数 认知功能障碍数 认知障碍率(%) 单因素分析 多因素分析 OR 值 95 % CI OR 值 95 % CI 植物类膳食模式 Q1 142 60 42.25 1.000 1.000 Q2 141 63 44.68 0.762 0.463~1.253 0.741 0.448~1.228 Q3 141 48 34.04 1.142 0.701~1.860 1.145 0.701~1.871 Q4 141 51 36.17 0.828 0.503~1.364 0.819 0.496~1.352 肉类膳食模式 Q1 141 54 38.30 1.000 1.000 Q2 141 54 38.30 0.708 0.433~1.157 0.680 0.414~1.118 Q3 141 51 36.17 0.716 0.436~1.174 0.691 0.418~1.142 Q4 142 63 44.36 0.582 0.374~1.098 0.570 0.336~0.967 水果蛋奶膳食模式 Q1 142 63 44.36 1.000 1.000 Q2 141 62 43.97 0.864 0.534~1.397 0.884 0.545~1.432 Q3 141 50 35.46 0.840 0.705~0.921 0.847 0.712~0.992 Q4 141 46 32.62 0.525 0.318~0.867 0.527 0.319~0.872 甜食膳食模式 Q1 142 68 47.89 1.000 1.000 Q2 141 53 37.59 0.909 0.542~1.523 0.945 0.558~1.598 Q3 141 54 38.30 0.712 0.419~1.209 0.732 0.427~1.252 Q4 141 48 34.04 1.190 0.728~1.943 1.276 0.764~2.129 -
[1] Alzheimer′s Association. 2019 Alzheimer′s disease facts and figures[J]. Alzheimer′s and Dementia, 2019, 15(3): 321 – 387. doi: 10.1016/j.jalz.2019.01.010 [2] Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: mild cognitive impairment: report of the guide-line development, dissemination, and implementation subcommittee of the American academy of neurology[J]. Neurology, 2018, 90(3): 126 – 135. doi: 10.1212/WNL.0000000000004826 [3] Cooper C, Sommerlad A, Lyketsos CG, et al. Modifiable predictors of dementia in mild cognitive impairment: a systematic review and meta-analysis[J]. The American Journal of Psychiatry, 2015, 172(4): 323 – 334. doi: 10.1176/appi.ajp.2014.14070878 [4] 杨帆, 王超, 毛宗福. 武汉市社区老年人轻度认知功能障碍患病现状及其影响因素分析[J]. 中国公共卫生, 2016, 32(12): 1705 – 1707. doi: 10.11847/zgggws2016-32-12-25 [5] Ito T, Tanisawa K, Kawakami R, et al. Dietary patterns and nutritional assessment in middle-aged and elderly men[J]. Nihon Koshu Eisei Zasshi, 2016, 63(11): 653 – 663. [6] Abbatecola AM, Russo M, Barbieri M. Dietary patterns and cognition in older persons[J]. Current Opinion in Clinical Nutrition and Metabolic Care, 2018, 21(1): 10 – 13. doi: 10.1097/MCO.0000000000000434 [7] 刘熹润, 李爽境, 黄闪闪, 等. 四川凉山地区成年居民膳食模式与高尿酸血症关系[J]. 中国公共卫生, 2020, 36(9): 1297 – 1301. doi: 10.11847/zgggws1122275 [8] World Health Organization. Guidelines for controlling and monitor-ing the tobacco epidemic[M]. Geneva: World Health Organiza-tion, 1998. [9] 王陇德. 中国居民营养与健康状况调查报告之一: 2002综合报告[M]. 北京: 人民卫生出版社, 2005. [10] Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician[J]. Journal of Psychiatric Research, 1975, 12(3): 189 – 198. doi: 10.1016/0022-3956(75)90026-6 [11] Román GC, Jackson RE, Gadhia R, et al. Mediterranean diet: the role of long-chain ω-3 fatty acids in fish; polyphenols in fruits, vegetables, cereals, coffee, tea, cacao and wine; probiotics and vitamins in prevention of stroke, age-related cognitive decline, and Alzheimer disease[J]. Revue Neurologique, 2019, 175(10): 724 – 741. doi: 10.1016/j.neurol.2019.08.005 [12] Chai SC, Jerusik J, Davis K, et al. Effect of Montmorency tart cherry juice on cognitive performance in older adults: a randomized controlled trial[J]. Food and Function, 2019, 10(7): 4423 – 4431. doi: 10.1039/C9FO00913B [13] Brouwer-Brolsma EM, Benati A, van de Wiel A, et al. Higher Mediterranean diet scores are not cross-sectionally associated with better cognitive scores in 20- to 70-year-old Dutch adults: the NQplus study[J]. Nutrition Research, 2018, 59: 80 – 89. doi: 10.1016/j.nutres.2018.07.013 [14] Ylilauri MPT, Voutilainen S, Lönnroos E, et al. Association of dietary cholesterol and egg intakes with the risk of incident dementia or Alzheimer disease: the Kuopio Ischaemic heart disease risk factor study[J]. The American Journal of Clinical Nutrition, 2017, 105(2): 476 – 484. doi: 10.3945/ajcn.116.146753 [15] Zhao X, Yuan L, Feng L, et al. Association of dietary intake and lifestyle pattern with mild cognitive impairment in the elderly[J]. The Journal of Nutrition, Health and Aging, 2015, 19(2): 164 – 168. [16] Ano Y, Ayabe T, Kutsukake T, et al. Novel lactopeptides in fermented dairy products improve memory function and cognitive decline[J]. Neurobiology of Aging, 2018, 72: 23 – 31. doi: 10.1016/j.neurobiolaging.2018.07.016 [17] Solfrizzi V, Custodero C, Lozupone M, et al. Relationships of dietary patterns, foods, and micro- and macro-nutrients with Alzheimer′s disease and late-life cognitive disorders: a systematic review[J]. Journal of Alzheimer's Disease, 2017, 59(3): 815 – 849. doi: 10.3233/JAD-170248 [18] Dong L, Xiao R, Cai C, et al. Diet, lifestyle and cognitive function in old Chinese adults[J]. Archives of Gerontology and Geriatrics, 2016, 63: 36 – 42. doi: 10.1016/j.archger.2015.12.003 [19] Yuan LH, Liu JM, Ma WW, et al. Dietary pattern and antioxidants in plasma and erythrocyte in patients with mild cognitive impair-ment from China[J]. Nutrition, 2016, 32(2): 193 – 198. doi: 10.1016/j.nut.2015.08.004
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