Abstract：
BACKGROUND: Long sedentary time and physical inactivity are negatively related to cognition, but the cut-off value remains unclear, and apolipoprotein E polymorphism ε4 (APOE ε4) is a known genetic risk factor of mild cognitive impairment (MCI).
OBJECTIVE: To explore longitudinal association of sedentary time and MCI, and to identify a cutoff value that increases the risk of developing MCI, taking into account APOE ε4 stratification and its interactions.
METHODS: A prospective cohort study.
METHODS: Population-based study.
METHODS: We included 4932 older adults from Tianjin Elderly Nutrition and Cognition (TENC) cohort study recruited from March 2018 to June 2021 with 3.11 years of median follow-up time.
METHODS: The primary outcome was newly diagnosed MCI, which was diagnosed by a modified version of the Petersen\'s criteria. The information of sedentary time (hours/day) and physical activity (MET-h/week) were obtained by questionnaire. Cox proportional hazard regression models and restricted spline curve were conducted.
RESULTS: A total of 4932 participants were included (mean [SD] age, 67.85 [4.96] years; 2627 female [53.3%] and 2305 male [46.7%]), 740 newly onset MCI patients were identified. Longer sedentary time was associated with higher risk of MCI for all participants (HR:1.069, 95%CI: 1.034, 1.105), especially in APOE ε4 non-carriers (HR:1.083, 95%CI: 1.045, 1.123) whether adjusted potential confounders. Sedentary time had synergistic interactions with APOE ε4 (β:1.503, 95%CI: 1.163, 1.942) and physical activities (β: 1.495, 95%CI: 1.210, 1.846). Restricted spline curve showed a cut-off value of 3.03 hours/day.
CONCLUSIONS: Long sedentary time (≥3.03 hours/day) could increase MCI risk, especially in APOE ε4 non-carriers, people with higher PA, aged 65 and above.
OBJECTIVE: To explore longitudinal association of sedentary time and MCI, and to identify a cutoff value that increases the risk of developing MCI, taking into account APOE ε4 stratification and its interactions.
METHODS: A prospective cohort study.
METHODS: Population-based study.
METHODS: We included 4932 older adults from Tianjin Elderly Nutrition and Cognition (TENC) cohort study recruited from March 2018 to June 2021 with 3.11 years of median follow-up time.
METHODS: The primary outcome was newly diagnosed MCI, which was diagnosed by a modified version of the Petersen\'s criteria. The information of sedentary time (hours/day) and physical activity (MET-h/week) were obtained by questionnaire. Cox proportional hazard regression models and restricted spline curve were conducted.
RESULTS: A total of 4932 participants were included (mean [SD] age, 67.85 [4.96] years; 2627 female [53.3%] and 2305 male [46.7%]), 740 newly onset MCI patients were identified. Longer sedentary time was associated with higher risk of MCI for all participants (HR:1.069, 95%CI: 1.034, 1.105), especially in APOE ε4 non-carriers (HR:1.083, 95%CI: 1.045, 1.123) whether adjusted potential confounders. Sedentary time had synergistic interactions with APOE ε4 (β:1.503, 95%CI: 1.163, 1.942) and physical activities (β: 1.495, 95%CI: 1.210, 1.846). Restricted spline curve showed a cut-off value of 3.03 hours/day.
CONCLUSIONS: Long sedentary time (≥3.03 hours/day) could increase MCI risk, especially in APOE ε4 non-carriers, people with higher PA, aged 65 and above.
摘要：
背景：长时间久坐和缺乏身体活动与认知呈负相关，但是截止值仍然不清楚，载脂蛋白E多态性ε4（APOEε4）是轻度认知障碍（MCI）的已知遗传危险因素。
目的：探讨久坐时间与MCI的纵向关联，并确定增加MCI风险的临界值，同时考虑APOEε4分层及其相互作用。
方法：前瞻性队列研究。
方法：基于人群的研究。
方法：我们纳入了从2018年3月至2021年6月招募的4932名来自天津市老年营养与认知（TENC）队列研究的老年人，中位随访时间为3.11年。
方法：主要结果是新诊断的MCI，通过Petersen标准的修改版本进行诊断。通过问卷调查获得久坐时间（小时/天）和身体活动（MET-h/周）的信息。采用Cox比例风险回归模型和受限样条曲线。
结果：共纳入4932名参与者（平均[SD]年龄，67.85[4.96]岁；2627名女性[53.3%]和2305名男性[46.7%]），确定了740例新发病的MCI患者。久坐时间越长，所有参与者的MCI风险越高（HR：1.069，95CI：1.034，1.105），特别是APOEε4非携带者(HR：1.083，95CI：1.045，1.123)是否调整了潜在的混杂因素。静坐时间与APOEε4（β：1.503，95CI：1.163，1.942）和体力活动（β：1.495，95CI：1.210，1.846）具有协同作用。受限样条曲线显示截止值为3.03小时/天。
结论：长时间久坐（≥3.03小时/天）可增加MCI风险，特别是在APOEε4非运营商中，PA较高的人，65岁及以上。
目的：探讨久坐时间与MCI的纵向关联，并确定增加MCI风险的临界值，同时考虑APOEε4分层及其相互作用。
方法：前瞻性队列研究。
方法：基于人群的研究。
方法：我们纳入了从2018年3月至2021年6月招募的4932名来自天津市老年营养与认知（TENC）队列研究的老年人，中位随访时间为3.11年。
方法：主要结果是新诊断的MCI，通过Petersen标准的修改版本进行诊断。通过问卷调查获得久坐时间（小时/天）和身体活动（MET-h/周）的信息。采用Cox比例风险回归模型和受限样条曲线。
结果：共纳入4932名参与者（平均[SD]年龄，67.85[4.96]岁；2627名女性[53.3%]和2305名男性[46.7%]），确定了740例新发病的MCI患者。久坐时间越长，所有参与者的MCI风险越高（HR：1.069，95CI：1.034，1.105），特别是APOEε4非携带者(HR：1.083，95CI：1.045，1.123)是否调整了潜在的混杂因素。静坐时间与APOEε4（β：1.503，95CI：1.163，1.942）和体力活动（β：1.495，95CI：1.210，1.846）具有协同作用。受限样条曲线显示截止值为3.03小时/天。
结论：长时间久坐（≥3.03小时/天）可增加MCI风险，特别是在APOEε4非运营商中，PA较高的人，65岁及以上。
