握力与认知功能障碍的性别差异研究：基于2011—2014美国健康和营养调查的横断面研究
摘要： 目的 探究握力与认知功能的关联是否存在性别差异。
方法 利用 2011—2014 年美国国家健康与营养调查(National Health and Nutrition Examination Survey，NHANES）数据库开展横断面研究，评估即时记忆、延迟记忆、言语流畅性和注意力4个认知领域。采用加权线性回归、加权Logistic回归、相乘模型进行分析。
结果 回归分析显示，在男性，与握力最低组的研究对象相比，握力最高组研究对象有更低的整体认知功能降低（OR=0.377,95%CI：0.182~0.781)和即时记忆降低(OR=0.409,95%CI：0.221~0.759)的风险。在女性，握力与整体认知功能降低（OR=0.405,95%CI：0.224~0.733)、言语流畅性降低(OR=0.567,95%CI：0.356~0.902)以及注意力降低(OR=0.357,95%CI：0.211~0.607)的风险呈显著负相关关系。同时，性别和握力在整体认知功能、言语流畅性和注意力均存在显著交互作用，但是即时记忆、延迟回忆2个认知领域未检测到显著的交互作用。
结论 握力对整体认知功能和不同认知领域的影响存在性别差异。因此，提高握力水平，特别是女性，有利于预防认知功能下降。
关键词: 认知功能障碍, 手部肌力, 性别因素
Abstract: Objective To investigate the gender difference in the association between grip strength and cognitive function.
Methods Cross-sectional study was conducted using database of the National Health and Nutrition Examination Survey (NHANES) 2011-2014, to evaluate four cognitive domains: immediate memory, delayed memory, speech fluency, and attention. Weighted linear regression, weighted Logistic regression and interaction analysis were applied.
Results Regression analysis showed that in males, compared with the group with the lowest grip strength, the group with the highest grip strength had a lower overall cognitive function decline (OR=0.377, 95%CI: 0.182-0.781) and a lower risk of immediate memory decline (OR=0.409, 95%CI: 0.221-0.759). In femlaes, grip strength was significantly and negatively correlated with overall cognitive function decline (OR=0.405, 95%CI: 0.224-0.733), decreased speech fluency (OR=0.567, 95%CI: 0.356-0.902), and decreased attention (OR=0.357, 95%CI: 0.211-0.607). Meanwhile, there was a significant interaction between gender and grip strength in overall cognitive function verbal fluency and attention, but no significant interaction was detected in the two cognitive domains of immediate memory, and delayed recall.
Conclusion There is significant gender difference in the association between grip strength and overall cognitive function and cognitive domains. The finding suggests that strengthening grip strength levels, especially in females, may be beneficial in preventing cognitive decline.
Key words: cognitive dysfunction, hand strength, gender factor
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