背景:在基于屏幕的久坐活动上花费的时间与痴呆风险显著相关,然而,目前尚不清楚这些关联是否因痴呆家族史(FHx)而异.我们旨在研究两种常见的基于屏幕的久坐活动(电视[TV]观看和计算机使用)与痴呆症的独立关联,并评估FHx的改善作用。
方法:我们纳入了来自英国生物库的415,048名没有痴呆的个体。看电视的协会,电脑使用,使用Cox回归模型确定具有痴呆风险的FHx。我们估计了电视观看和计算机使用与FHx之间的多重性和加性相互作用。
结果:在12.6年的中位随访期间,5549名参与者患上了痴呆症。在调整了潜在的混杂因素后,我们观察到中度(2-3小时/天;风险比[HR]1.13,95%置信区间0.03-1.23)和高(&gt;3小时/天;1.33,1.21-1.46)看电视与较高的痴呆风险相关,与低(0-1小时/天)电视观看相比。使用受限制的三次样条模型,看电视与痴呆的关系是非线性的(相对于0小时/天;非线性的p=0.005)。我们发现,每天看电视3小时与FHx参与者的痴呆风险增加42%(1.42,1.18-1.71)相关,而没有FHx的参与者则为30%(1.30,1.17-1.45)。对于计算机使用,低(0小时/天;1.41,1.33-1.50)和高(>2小时/天;1.17,1.05-1.29)计算机使用与痴呆风险升高相关,与适度(1-2小时/天)使用计算机相比。我们观察到与痴呆呈J形关系(相对于2小时/天;p为非线性<0.001)。与每天使用电脑1-2小时相比,FHx患者使用电脑0小时/天和2小时/天的痴呆患者的HR分别为1.46(1.29-1.65)和1.10(0.90-1.36),分别,而没有FHx的患者的相应HR分别为1.40(1.30-1.50)和1.19(1.06-1.33)。我们观察到计算机使用和FHx之间存在正的加性相互作用(RERI0.29,0.06-0.53),虽然几乎没有证据表明电视观看和FHx之间存在相互作用。
结论:看电视和使用电脑的时间是痴呆的独立危险因素,计算机使用和FHx的不利影响是累加的。我们的发现指出了预防痴呆症早期发作的干预新的行为目标,尤其是那些有FHx的人。
BACKGROUND: Time spent on screen-based sedentary activities is significantly associated with dementia risk, however, whether the associations vary by family history (FHx) of dementia is currently unknown. We aimed to examine independent associations of two prevalent types of screen-based sedentary activities (television [TV] viewing and computer use) with dementia and assess the modifying effect of FHx.
METHODS: We included 415,048 individuals free of dementia from the UK Biobank. Associations of TV viewing, computer use, and FHx with dementia risk were determined using Cox regression models. We estimated both multiplicative- and additive-scale interactions between TV viewing and computer use and FHx.
RESULTS: During a median follow-up of 12.6 years, 5,549 participants developed dementia. After adjusting for potential confounding factors, we observed that moderate (2-3 h/day; hazard ratio [HR] 1.13, 95% confidence interval 0.03-1.23) and high (>3 h/day; 1.33, 1.21-1.46) TV viewing was associated with a higher dementia risk, compared with low (0-1 h/day) TV viewing. Using restricted cubic spline models, the relationship of TV viewing with dementia was nonlinear (relative to 0 h/day; p for nonlinear = 0.005). We found that >3 h/day of TV viewing was associated with a 42% (1.42, 1.18-1.71) higher dementia risk in participants with FHx while a 30% (1.30, 1.17-1.45) in those without FHx. For computer use, both low (0 h/day; 1.41, 1.33-1.50) and high (>2 h/day; 1.17, 1.05-1.29) computer use were associated with elevated dementia risk, compared with moderate (1-2 h/day) computer use. We observed a J-shaped relationship with dementia (relative to 2 h/day; p for nonlinear <0.001). Compared with 1-2 h/day of computer use, the HRs of dementia were 1.46 (1.29-1.65) and 1.10 (0.90-1.36) for 0 h/day and >2 h/day of computer use in participants with FHx, respectively, while the corresponding HRs were 1.40 (1.30-1.50) and 1.19 (1.06-1.33) in those without FHx. We observed a positive additive interaction (RERI 0.29, 0.06-0.53) between computer use and FHx, while little evidence of interaction between TV viewing and FHx.
CONCLUSIONS: The time spent on TV viewing and computer use were independent risk factors for dementia, and the adverse effects of computer use and FHx were additive. Our findings point to new behavioral targets for intervention on preventing an early onset of dementia, especially for those with FHx.