认知与发展心理学研究室知识库

随着社会和医学的进步，人类寿命不断增长。与此同时，人口老龄化问题逐渐加剧。由于增龄带来的机体代谢和免疫功能减弱，慢性疾病易感性增加等问题逐渐凸显，同时由于老年人的脑灰质体积持续萎缩，认知功能也相应的持续下降。已有研究表明，健康的生活方式有助于延缓老年人的认知功能下降。本文拟通过横断分析和模拟干预两种方法，系统探讨生活方式因素对中国老年人认知功能的影响及改善效果。

本文包含两项研究。研究一为横断分析，采用了中国健康寿命纵向调查(Chinese Longitudinal Healthy Longevity Survey, CLHLS)2011/2012 年 8773 名被试(平均年龄: 85.86±11.42 岁，55.4%为女性)数据进行多元线性回归分析，探讨吸烟、 饮酒、体育运动、社会活动、休闲活动及饮食等生活方式因素对老年人认知功能的影响；在此基础上，研究二进一步通过模拟干预方法，以 2011/12 年数据为基线，2014、2018 年数据为两次追踪数据，利用 G-formula 参数模型方法对生活方式因素进行模拟干预，探究生活方式改善对老年人认知功能的提升效果。

研究一结果表明，增加社会活动、休闲活动参与度及增加有益饮食(蔬菜、水果、鱼类、豆类、牛奶、坚果及茶)摄入有助于延缓老年人的认知功能下降。高频率看电视或听收音机、打牌/麻将等休闲活动，以及增加鱼类摄入对不同性别、不同年龄老年人均有显著正向预测作用，饮酒对 80 岁以上老年人认知功能具有显著负向预测作用。

研究二模拟干预结果表明，积极参与休闲活动和社交活动，增加蔬菜、水果、鱼类和坚果摄入均能显著提升老年人认知功能。此外，生活方式各因素的联合模拟干预可以带来更好的干预效果，且干预因素越多、认知功能提升越明显。两因素联合干预中，休闲活动和饮食联合干预对认知功能具有最佳提升效果。

总体来看，本研究发现积极的生活方式如积极参与社交活动、休闲活动及增加健康饮食摄入有助于延缓老年人认知功能下降。模拟干预表明，戒酒、积极参 与休闲活动、家务劳动及增加健康饮食摄入可显著改善老年人的认知功能。老年人认知功能的改善，不仅可以提升老年人生活质量，促进健康老龄化的实现，而且可以减轻家庭和社会的经济负担。相比于以往研究，本研究聚焦于难以开展现场干预的生活方式因素，丰富了认知功能领域干预研究，同时扩展了 G-formula参数模型的应用领域，为维持与提升老年人认知功能提供了较为坚实的证据支撑。

With the advancement of society and medicine, human life expectancy continues to increase. At the same time, the problem of population aging is gradually intensifying. Due to the weakening of body metabolism and immune function caused by aging, the susceptibility to chronic diseases increases. Meanwhile, due to the continuous atrophy of gray matter volume in older adults, cognitive function also continues to decline accordingly. Previous studies have shown that a healthy lifestyle can help delay the decline of cognitive function in older adults. This article intends to systematically explore the impact of lifestyle factors on cognitive function and the improvement effect of Chinese older adults through two methods: cross-sectional analysis and simulation intervention.

This article includes two studies. Study 1 used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2011/2012 on 8773 subjects (mean age: 85.86±11.42 years, 55.4% female) to conduct multiple linear regression analysis to explore the effects of lifestyle factors such as smoking, drinking, physical exercise, social activities, leisure activities and diet on cognitive function in older adults; On this basis, Study 2 further adopted the simulation intervention method, using the 2011/12 data as the baseline, and the data of 2014 and 2018 as the two follow-up data, and used the G-formula parameter model method to simulate the intervention of lifestyle factors to explore the effect of lifestyle improvement on the improvement of cognitive function in older adults.

The results of the Study 1 showed that increasing participation in social and leisure activities and increasing the intake of beneficial diet could help delay the decline of cognitive function in older adults. Frequent leisure activities such as watching TV or listening to the radio, playing cards/mahjong, and increasing fish intake have significant positive predictive effects on older adults of different genders and ages, and drinking has a significant negative predictive effect on cognitive function in the elderly over 80 years old.

The results of the simulation intervention in Study 2 showed that active participation in leisure and social activities, and increasing the intake of vegetables, fruits, fish and nuts intake can significantly improve the cognitive function of older adults. In addition, the combination simulation intervention of lifestyle factors can bring better intervention effects, and the more intervention factors, the more obvious the improvement of cognitive function. Among the two-factor combined interventions, the combined intervention of leisure activities and diet has the best effect on improving cognitive function.

Overall, this study found that an active lifestyle, such as active participation in social activities, leisure activities, and increased intake of healthy diets, can help delay cognitive decline in older adults. Simulation interventions showed that abstinence from alcohol, active participation in social activities, housework, and increased intake of healthy food can significantly improve cognitive function in older adults. The improvement of cognitive function can not only improve the quality of life of older adults and promote the realization of healthy aging, but also reduce the economic burden of the families and society. Compared with previous studies, this study focuses on lifestyle factors that are difficult to carry out on-site, enriches the intervention studies in the field of cognitive function, and expands the application field of G-formula parameter model, providing a relatively solid support for maintaining and improving cognitive function in older adults.