臺灣博碩士論文加值系統

背景: 過去的研究發現休閒活動可以降低失智症風險，但結果並不一致。因此，本研究想探討不同種類的休閒活動與失智症風險之關聯性。
方法: 本研究為病歷對照組設計。總共有470位年齡皆為50歲以上的失智症病人(310位阿滋海默氏症及160位血管性失智症)。病歷組來自北台灣三間教學醫院神經科門診，健康對照組則來自其中一家教學醫院健康檢查及志工，收案期間為2007至2010年。
結果：高頻率身體活動顯著降低阿滋海默氏症的風險(OR= 0.46, 95% CI = 0.32-0.70)。依性別分層之後，阿滋海默氏症風險依舊降低，但程度因男女不同(男性: OR= 0.37；女性: OR= 0.57)。高頻率的娛樂、認知、創造性活動及社會參與活動皆可降低阿滋海默氏症風險，(前者: OR= 0.37，95% CI= 0.18-0.77；後者: OR= 0.55，95% CI= 0.38-0.79)。高頻率的娛樂、認知、創造性活動顯著降低女性的阿滋海默氏症風險(OR= 0.22, 95% CI= 0.08-0.60)，而社會參與活動則顯著降低男性阿滋海默氏症風險(OR= 0.48, 95% CI= 0.27-0.86)。此外，高頻率的身體活動及娛樂、認知、創造性活動顯著地降低血管型失智症風險，(前者: OR= 0.31, 95% CI = 0.18-0.54；後者: OR= 0.24, 95% CI = 0.10-0.60)。不論男性或女性，身體活動均可以降低血管型失智症(男生: OR= 0.25；女生: OR= 0.41)。娛樂、認知、創造性活動僅能降低男性的血管型失智症(OR= 0.26, 95% CI = 0.08-0.85)。
結論: 高頻率身體活動及娛樂、認知、創造性活動及社會參與活動對於阿滋海默氏症扮演著保護角色，但只有前面兩種活動能降低血管型失智症風險。此外，這些關係亦隨性別而有所變化。最後，任意二種不同的休閒活動並無顯著的交互作用。

Background: Previous studies found that leisure activities may decrease the risk of dementia, but results were inconsistent. Therefore, this study explored the association between different leisure activities and the risk of dementia.
Methods: This is a case-control study. A total of 470 dementia patients [310 Alzheimer''s disease (AD) and 160 vascular dementia (VaD)] aged 50 or order was recruited from three teaching hospitals in northern Taiwan between 2007 and 2010. Health controls (n=499) were recruited from health checkup and volunteers of one hospital during the same time.
Results: High frequency of physical activity was associated with a reduced risk of AD [odds ratio (OR) = 0.46, 95% confidence interval (CI) = 0.32-0.70)], results remained significant after stratified by gender (men: OR= 0.37; women: OR= 0.57). Similar finding was observed for high frequency of recreational, cognitive, productive activity (OR= 0.37, 95% CI= 0.18-0.77), and result remained significant among women (OR= 0.22), but not among men. Same for high social engagement activity (OR= 0.55, 95% CI= 0.38-0.79), but result remained significant only among men (OR= 0.48). For VaD, high frequency of physical activity and recreational, cognitive, productive activities were associated with a reduced risk of VaD (OR= 0.31, 95% CI = 0.18-0.54; OR= 0.24, 95% CI = 0.10-0.60, respectively). Physical activity was associated with a reduced risk of VaD after stratified by gender (men: OR= 0.25; women: OR= 0.41). Recreational, cognitive, productive activity was associated with a lower VaD risk in men (OR= 0.26, 95% CI= 0.08-0.85).
Conclusion: High frequency of physical activity; recreational, cognitive, productive activity; and social engagement activity played a protective role on the risk of AD. Only the former two activities were associated with VaD. In addition, the associations were varied by gender. No interactions were observed for any two types of activities on the risk of AD and VaD.

誌 謝 II
中文摘要 IV
ABSTRACT V
CONTENTS VII
LIST OF FIGURES VIII
LIST OF TABLES IX
CHAPTER 1. INTRODUCTION 1
1.1 Background of dementia 1
1.2 The definition and types of leisure activities 1
1.3 Previous studies on leisure activities with dementia 2
1.4 Aims of this study 2
CHAPTER 2. METHODS AND MATERIALS 3
2.1 Study population 3
2.2 Diagnosis of dementia 3
2.3 Leisure activities 4
2.4 Statistical analysis 5
CHAPTER 3. RESULTS 6
3.1 Demographic characteristics 6
3.2 The association of leisure activities with the risk of AD and VaD 6
3.3 The association of leisure activities with the risk of AD and VaD by gender 6
3.4 The association of leisure activities with the risk of AD and VaD by years since retirement 7
3.5 The interactions between individual leisure activities on the risk of AD and VaD 8
CHAPTER 4. DISCUSSION 9
4.1 Main findings 9
4.2 Postulated mechanism between leisure activities and the risk of AD and VaD 11
4.3 Strengths and limitations 11
CHAPTER 5. CONCLUSION 13
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