中年的运动将会对以后的大脑大有裨益

What you do for your heart in midlife may also shape how well your brain ages. Credit: Shutterstock 中年时期你对心脏的保养方式，或许也会影响你的大脑衰老速度。图片来源：Shutterstock

Physical activity and healthy blood sugar levels during midlife may be linked to a significantly slower decline in thinking abilities later in life, according to new research from UT Health San Antonio, the academic health center of The University of Texas at San Antonio. The findings suggest that exercise may be especially important for Hispanic adults. 德克萨斯大学圣安东尼奥分校附属学术医疗中心 UT Health San Antonio 的一项最新研究表明，中年时期保持体育锻炼和健康的血糖水平可能与晚年思维能力下降速度显著减缓有关。研究结果还表明，运动对西班牙裔成年人尤为重要。

Scientists already know that cardiovascular problems in midlife can raise the risk of cognitive decline and dementia. This study is among the first to investigate how specific cardiovascular health factors may relate to cognitive aging across different ethnic groups. 科学家们已经知道，中年时期的心血管疾病会增加认知能力下降和痴呆的风险。这项研究是首批探讨特定心血管健康因素如何与不同种族群体的认知老化相关的研究之一。

Researchers analyzed 402 people from San Antonio. Of the participants, 52% were Hispanic, and the rest were non-Hispanic white. Their mean age was 57.9, and 58.5% were women. 研究人员分析了来自圣安东尼奥的402人的数据。其中，52%为西班牙裔，其余为非西班牙裔白人。他们的平均年龄为57.9岁，58.5%为女性。

The findings varied by ethnicity. Physical activity was particularly associated with slower cognitive decline among Hispanic participants, while lower fasting blood glucose levels were linked to slower cognitive decline among non-Hispanic white participants. 研究结果因种族而异。体育锻炼与西班牙裔参与者认知能力下降速度减缓尤为相关，而空腹血糖水平较低则与非西班牙裔白人参与者认知能力下降速度减缓相关。

“By improving cardiovascular health through modifiable lifestyle changes, there is a potential to meaningfully alleviate the public health burden of Alzheimer’s disease and other dementias, particularly in high-risk populations,” said Claudia Satizabal, PhD, associate professor in the Department of Population Health Sciences at UT Health San Antonio and its Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, where she leads the Population Neuroscience Core. “通过改变生活方式来改善心血管健康，有可能显著减轻阿尔茨海默病和其他痴呆症给公众带来的健康负担，尤其是在高危人群中，”德克萨斯大学圣安东尼奥健康科学中心人口健康科学系副教授、格伦·比格斯阿尔茨海默病和神经退行性疾病研究所的格伦·比格斯博士说道，她领导着该研究所的人口神经科学核心。

Satizabal is co-senior author of the study with Chen-Pin Wang, PhD, associate professor-research in the Department of Population Health Sciences. The research, titled “Longitudinal association between midlife cardiovascular health and cognitive change in a bi-ethnic cohort,” was published July 23 by Alzheimer’s & Dementia: Behavior & Socioeconomics of Aging. Satizabal 与人口健康科学系副教授兼研究员 Chen-Pin Wang 博士共同担任该研究的资深作者。这项题为“双族裔队列中中年心血管健康与认知变化之间的纵向关联”的研究于 7 月 23 日发表在 《阿尔茨海默病与痴呆：老龄化行为与社会经济学》期刊上。

All of the study authors are affiliated with either the Glenn Biggs Institute or The University of Texas Rio Grande Valley. 该研究的所有作者均隶属于格伦·比格斯研究所或德克萨斯大学里奥格兰德河谷分校。

Cardiovascular Health and Dementia Risk 心血管健康与痴呆风险

As people around the world live longer and the proportion of older adults grows, age-related conditions such as dementia are becoming increasingly common. The study notes that 6.7 million people in the United States currently have Alzheimer’s disease. 随着世界各地人们寿命的延长和老年人口比例的不断增长，诸如痴呆症等与年龄相关的疾病也变得越来越普遍。该研究指出，目前美国有670万人患有阿尔茨海默病。

At the same time, research increasingly suggests that many risk factors for cognitive decline and dementia can be modified. Recent estimates indicate that nearly 40% of Alzheimer’s cases may be connected to such factors. Cardiovascular health, in particular, has emerged as an important influence on how the brain ages. 与此同时，越来越多的研究表明，许多认知能力下降和痴呆的风险因素是可以改变的。近期估计显示，近40%的阿尔茨海默病病例可能与这些因素有关。尤其值得一提的是，心血管健康已成为影响大脑衰老的重要因素。

One widely used approach for measuring cardiovascular health is the American Heart Association’s Life’s Simple 7 (LS7) framework. It includes three behavioral factors (healthy diet, non-smoking, and physical activity) and four health factors (blood pressure, body mass index, total cholesterol and fasting blood glucose). According to the study, LS7 provides an overall measure of cardiovascular health and has also been proposed as a way to support better brain health. 衡量心血管健康的一种常用方法是美国心脏协会的“生命七要素”（LS7）框架。该框架包含三个行为因素（健康饮食、不吸烟和体育锻炼）和四个健康因素（血压、体重指数、总胆固醇和空腹血糖）。研究表明，LS7 框架能够全面衡量心血管健康状况，并且也被认为有助于改善大脑健康。

Previous research has found that stronger adherence to LS7 is associated with better cognitive performance, healthier brains, and a lower risk of dementia. However, these relationships do not appear to be identical across different populations. 先前的研究发现，更严格地遵循 LS7 原则与更好的认知能力、更健康的大脑以及更低的痴呆风险相关。然而，这些关系在不同人群中似乎并不完全相同。

Hispanic older adults face a disproportionate burden of Alzheimer’s disease and related dementias. About 14% of Hispanic adults aged 65 or older have Alzheimer’s, compared with 10% of non-Hispanic white older adults. Mexican Americans, who make up the largest Hispanic population in the United States, also have particularly high rates of diabetes, obesity and dyslipidemia, conditions that can increase dementia risk. 西班牙裔老年人面临着阿尔茨海默病及相关痴呆症不成比例的沉重负担。65岁及以上的西班牙裔成年人中，约有14%患有阿尔茨海默病，而非西班牙裔白人老年人的这一比例为10%。墨西哥裔美国人是美国最大的西班牙裔群体，他们的糖尿病、肥胖症和血脂异常的发病率也特别高，这些疾病都会增加患痴呆症的风险。

Why South Texas Offers Important Insights 为什么德克萨斯州南部能提供重要的见解

Despite these disparities, Hispanic populations remain underrepresented in Alzheimer’s research. The researchers note that this lack of representation makes it more difficult to understand how dementia risk develops over time and to identify prevention strategies that may work effectively for everyone. 尽管存在这些差异，西班牙裔人群在阿尔茨海默病研究中的代表性仍然不足。研究人员指出，这种代表性的缺失使得人们更难了解痴呆风险如何随时间发展，也难以找到对所有人都有效的预防策略。

To help address that gap, the UT Health San Antonio team investigated the relationship between cardiovascular health in midlife, measured through LS7 scores, and later cognitive decline among Mexican American and non-Hispanic white older adults. The participants had previously taken part in the San Antonio Heart Study (SAHS) and the San Antonio Longitudinal Study of Aging (SALSA). 为了弥补这一研究空白，德克萨斯大学圣安东尼奥健康科学中心的研究团队调查了墨西哥裔美国人和非西班牙裔白人老年人中年时期的心血管健康状况（通过 LS7 评分衡量）与后期认知能力下降之间的关系。这些参与者此前曾参与过圣安东尼奥心脏研究（SAHS）和圣安东尼奥老龄化纵向研究（SALSA）。

The SAHS was a landmark, long-term project led by UT Health San Antonio to investigate the causes of Type 2 diabetes and heart disease. Conducted from 1979 through the 2000s, the project followed more than 5,000 people to better understand why certain ethnic populations experience higher health risks. 圣安东尼奥健康研究（SAHS）是由德克萨斯大学圣安东尼奥健康科学中心牵头的一项具有里程碑意义的长期项目，旨在调查 2 型糖尿病和心脏病的病因。该项目从 1979 年持续到 21 世纪初，追踪了 5000 多人，以更好地了解为什么某些族裔群体面临更高的健康风险。

SALSA later grew out of that work. Also conducted by UT Health San Antonio, it became a major, long-term observational study focused on chronic diseases, healthy aging and the process through which older adults develop disabilities. Its participants had previously been enrolled in the SAHS. SALSA 研究正是在此基础上发展起来的。同样由德克萨斯大学圣安东尼奥健康科学中心开展的 SALSA 研究，是一项大型的长期观察性研究，重点关注慢性疾病、健康老龄化以及老年人残疾的发生过程。其参与者此前均已加入 SAHS 研究。

“Importantly, the inclusion of both ethnic groups from the same source population and geographic setting allows for direct comparison within a shared contextual framework and strengthens our ability to identify disparities in cognitive aging and their cardiovascular correlates,” the new study notes. “重要的是，纳入来自同一来源人口和地理环境的两个族裔群体，可以在共同的背景框架内进行直接比较，并增强我们识别认知老化及其心血管相关性差异的能力，”这项新研究指出。

Tracking Cognitive Changes Over Time 追踪认知随时间的变化

For the new analysis, researchers evaluated cardiovascular health among SAHS participants who were later enrolled in SALSA, using their LS7 scores. 在新的分析中，研究人员使用 LS7 评分评估了后来加入 SALSA 的 SAHS 参与者的心血管健康状况。

Cognitive ability was measured as many as four times with the Mini-Mental State Examination, an established 11-question screening test that evaluates memory, attention and thinking skills. 认知能力最多使用简易精神状态检查（MMSE）测量了四次，MMSE 是一项成熟的 11 题筛查测试，用于评估记忆力、注意力和思维能力。

The team also used generalized estimating equation models to examine how cardiovascular factors were related to changes in cognition. The statistical models accounted for age, sex, income, and education. 研究团队还运用广义估计方程模型来分析心血管因素与认知变化之间的关系。统计模型考虑了年龄、性别、收入和教育程度等因素。

Researchers additionally performed sensitivity analyses to assess attrition bias. These extra statistical checks were designed to determine whether people dropping out of the study could have distorted the final results. 研究人员还进行了敏感性分析，以评估样本流失偏差。这些额外的统计检验旨在确定退出研究的人员是否可能扭曲最终结果。

Exercise and Blood Sugar Show Different Links 运动与血糖的关系各不相同

The analysis found that engaging in any physical activity, rather than living a sedentary lifestyle, was particularly associated with slower cognitive decline among Mexican Americans. 分析发现，与久坐不动的生活方式相比，参与任何体育活动都与墨西哥裔美国人认知能力下降速度减缓特别相关。

Fasting glucose also emerged as an important factor. This measurement reflects the amount of sugar in the blood after an eight- to 12-hour fast. Among non-Hispanic white participants, fasting glucose readings of 126 milligrams per deciliter or lower were associated with a slower rate of cognitive decline. 空腹血糖也是一个重要因素。该指标反映的是禁食8至12小时后血液中的糖分含量。在非西班牙裔白人参与者中，空腹血糖读数低于或等于126毫克/分升与认知能力下降速度较慢相关。

“Our findings suggest that engaging in any level of physical activity and potentially maintaining optimal fasting blood glucose levels in midlife are associated with a significantly slower rate of cognitive decline in late life,” said Janette Vazquez, PhD, first author of the study and currently a senior postdoctoral fellow at the Glenn Biggs Institute. But since the results differed by ethnicity, further research is needed in larger samples to replicate the differences, she said. “我们的研究结果表明，中年时期进行任何程度的体育锻炼，并可能保持最佳的空腹血糖水平，都与晚年认知能力下降速度显著减缓有关，”该研究的第一作者、格伦·比格斯研究所高级博士后研究员珍妮特·瓦兹奎兹博士说。但她也指出，由于研究结果因种族而异，因此需要更大样本量的研究来验证这些差异。

The findings suggest that cardiovascular health during midlife could influence cognitive aging many years later, but they also indicate that the most important factors may not be the same for every population. 研究结果表明，中年时期的心血管健康状况可能会影响多年后的认知老化，但同时也表明，对于每个群体而言，最重要的因素可能并不相同。

“The longitudinal exploration of cardiovascular health throughout life, rather than assessing it at a single time point, could also provide further insight into the trajectory phenotypes contributing to cognitive decline by ethnicity,” Vazquez said. 瓦兹奎兹说：“对整个生命周期的心血管健康状况进行纵向探索，而不是在单一时间点进行评估，还可以进一步深入了解导致不同种族认知能力下降的轨迹表型。”

Participants from the study are now being invited to join the San Antonio Heart and Mind Study (SAHMS) at the Glenn Biggs Institute. Researchers hope the ongoing project will generate additional discoveries by collecting state-of-the-art brain imaging and other neurological data. 参与这项研究的受试者现在受邀加入格伦·比格斯研究所的圣安东尼奥心脏与大脑研究（SAHMS）。研究人员希望这项正在进行的项目能够通过收集最先进的脑成像和其他神经学数据，带来更多发现。