以社区为基础的外出活动与日本老年人痴呆发病:一项纵向观察研究。

Masanori Morikawa, Kenji Harada, Satoshi Kurita, Chiharu Nishijima, Kazuya Fujii, Daisuke Kakita, Yukari Yamashiro, Naoto Takayanagi, Motoki Sudo, Hiroyuki Shimada
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引用次数: 0

摘要

随着全球老年人痴呆症患病率的上升,迫切需要有效和可扩展的社区干预措施来减少痴呆症的发病。本研究旨在评估老年人外出活动与痴呆发病的关系。方法:采用5年纵向观察研究。在2015年和2017年的基线评估之后,我们在日本观察了2977人参加了为期12个月的社区外出计划。连续数据超过12个月的参与者被定义为参与组,而没有这些数据的参与者被归类为非参与组。经倾向评分匹配后,选取1690名参与者。痴呆发病情况从日本国民健康保险和后期医疗保健系统获得,随访48个月。计算痴呆的发生率、绝对风险降低(ARR)和需要治疗的人数(NNT)。Cox比例风险模型用于估计参与该计划对痴呆发病的影响,并计算风险比和95%置信区间(CI)。结果:非参与组845人中有59人(7.0%)发生痴呆,参与组845人中有34人(4.0%)发生痴呆。ARR为3.0% (95% CI 0.8, 5.2), NNT为33 (95% CI 19, 125)。风险比为0.57 (95% CI 0.37, 0.86)。讨论:参与户外活动导致痴呆发病风险降低3.0%。可以在社区中实施的“外出”计划,在预防痴呆症发作方面具有潜在功效。
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Community-based going-out program and dementia onset in Japanese older adults: A longitudinal observational study.

Objectives: With dementia prevalence rising globally among older adults, effective and scalable community-based interventions are urgently needed to reduce dementia onset. This study aimed to estimate the association of the going-out program with dementia onset in older adults.

Methods: A 5-year longitudinal observational study was employed. Following a baseline assessment in 2015 and 2017, we observed 2,977 individuals engaging in a community-based going-out program for 12 months in Japan. Participants with continuous data over 12 months were defined as the engaged group, while those without such data were classified as the non-engaged group. After propensity score matching, 1,690 participants were selected. Dementia onset was obtained from the Japanese National Health Insurance and Later-Stage Medical Care System for 48-month follow-up. Incidence of dementia, absolute risk reduction (ARR), and number needed to treat (NNT) were calculated. The Cox proportional hazards model was used to estimate the effect of engagement in the program on dementia onset and to calculate a hazard ratio and 95 % confidential interval (CI).

Results: The incidence of dementia onset was 59 out of 845 (7.0 %) in the non-engagement group and 34 out of 845 (4.0 %) in the engagement group. The ARR rate was 3.0 % (95 % CI 0.8, 5.2), and the NNT was 33 (95 % CI 19, 125). The hazard ratio was 0.57 (95 % CI 0.37, 0.86).

Discussion: Engagement in the going-out program resulted in a 3.0 % reduction in the risk of dementia onset. The going-out program, which can be implemented in communities, holds potential efficacy in preventing dementia onset.

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