{"title":"老年人的生活空间活动与痴呆:来自队列研究的见解。","authors":"Takehiko Doi PhD, Keitaro Makino PhD, Kouki Tomida PhD, Kota Tsutsumimoto PhD, Fumio Sakimoto PhD, Soichiro Matsuda PhD, Hiroyuki Shimada PhD","doi":"10.1016/j.jamda.2024.105416","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>This study examined the association between life-space activities and incident dementia among older adults.</div></div><div><h3>Study Design</h3><div>A prospective study.</div></div><div><h3>Setting and Participants</h3><div>This study included 2740 older adults (mean age 74.4 years; SD ± 6.2 years; range 65–99 years; 58.8% women).</div></div><div><h3>Methods</h3><div>Life-space activities were assessed using the Active Mobility Index (AMI). Incident dementia was determined using medical insurance data and long-term care insurance data (mean follow-up, 53.7 months).</div></div><div><h3>Results</h3><div>During the follow-up period, 326 participants (11.9%) had incident dementia. Participants were classified into 3 groups based on AMI score tertiles: tertile 1, ≤52; tertile 2, 53–77; and tertile 3, ≥78. The Cox proportional hazards model was used to examine the association between AMI scores and incident dementia. Individuals with higher scores had lower hazard ratios (HRs) (tertile 1: reference; tertile 2: adjusted HR, 0.76, 95% CI, 0.59–0.97, <em>P</em> = .027; tertile 3: adjusted HR, 0.49, 95% CI, 0.36–0.68, <em>P</em> < .001; <em>P</em> for trend: <.001). Both the physical and social AMI sub-scores were associated with dementia (<em>P</em> for trend: <.001).</div></div><div><h3>Conclusions and Implications</h3><div>Restricted life-space activity, as assessed using the AMI, was associated with the risk of dementia. In addition, both the physical and social sub-scores were associated with dementia.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105416"},"PeriodicalIF":4.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Life-Space Activities and Incident Dementia Among Older Adults: Insights From a Cohort Study\",\"authors\":\"Takehiko Doi PhD, Keitaro Makino PhD, Kouki Tomida PhD, Kota Tsutsumimoto PhD, Fumio Sakimoto PhD, Soichiro Matsuda PhD, Hiroyuki Shimada PhD\",\"doi\":\"10.1016/j.jamda.2024.105416\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>This study examined the association between life-space activities and incident dementia among older adults.</div></div><div><h3>Study Design</h3><div>A prospective study.</div></div><div><h3>Setting and Participants</h3><div>This study included 2740 older adults (mean age 74.4 years; SD ± 6.2 years; range 65–99 years; 58.8% women).</div></div><div><h3>Methods</h3><div>Life-space activities were assessed using the Active Mobility Index (AMI). Incident dementia was determined using medical insurance data and long-term care insurance data (mean follow-up, 53.7 months).</div></div><div><h3>Results</h3><div>During the follow-up period, 326 participants (11.9%) had incident dementia. Participants were classified into 3 groups based on AMI score tertiles: tertile 1, ≤52; tertile 2, 53–77; and tertile 3, ≥78. The Cox proportional hazards model was used to examine the association between AMI scores and incident dementia. Individuals with higher scores had lower hazard ratios (HRs) (tertile 1: reference; tertile 2: adjusted HR, 0.76, 95% CI, 0.59–0.97, <em>P</em> = .027; tertile 3: adjusted HR, 0.49, 95% CI, 0.36–0.68, <em>P</em> < .001; <em>P</em> for trend: <.001). Both the physical and social AMI sub-scores were associated with dementia (<em>P</em> for trend: <.001).</div></div><div><h3>Conclusions and Implications</h3><div>Restricted life-space activity, as assessed using the AMI, was associated with the risk of dementia. In addition, both the physical and social sub-scores were associated with dementia.</div></div>\",\"PeriodicalId\":17180,\"journal\":{\"name\":\"Journal of the American Medical Directors Association\",\"volume\":\"26 2\",\"pages\":\"Article 105416\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Medical Directors Association\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1525861024008387\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Medical Directors Association","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1525861024008387","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Life-Space Activities and Incident Dementia Among Older Adults: Insights From a Cohort Study
Objectives
This study examined the association between life-space activities and incident dementia among older adults.
Study Design
A prospective study.
Setting and Participants
This study included 2740 older adults (mean age 74.4 years; SD ± 6.2 years; range 65–99 years; 58.8% women).
Methods
Life-space activities were assessed using the Active Mobility Index (AMI). Incident dementia was determined using medical insurance data and long-term care insurance data (mean follow-up, 53.7 months).
Results
During the follow-up period, 326 participants (11.9%) had incident dementia. Participants were classified into 3 groups based on AMI score tertiles: tertile 1, ≤52; tertile 2, 53–77; and tertile 3, ≥78. The Cox proportional hazards model was used to examine the association between AMI scores and incident dementia. Individuals with higher scores had lower hazard ratios (HRs) (tertile 1: reference; tertile 2: adjusted HR, 0.76, 95% CI, 0.59–0.97, P = .027; tertile 3: adjusted HR, 0.49, 95% CI, 0.36–0.68, P < .001; P for trend: <.001). Both the physical and social AMI sub-scores were associated with dementia (P for trend: <.001).
Conclusions and Implications
Restricted life-space activity, as assessed using the AMI, was associated with the risk of dementia. In addition, both the physical and social sub-scores were associated with dementia.
期刊介绍:
JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates.
The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality