Objective To examine associations between the amount and changes in regular physical activity (PA) before and after diagnosis of dementia and all-cause mortality risk, and whether these associations differ by PA intensity (light, moderate or vigorous). Methods This retrospective cohort study used data from the Korean National Health Insurance Service Database, including 60 252 individuals newly diagnosed with dementia between 2010 and 2016 who underwent health examinations both before and after diagnosis. PA was assessed using the International Physical Activity Questionnaire–Short Form. Multivariable Cox proportional hazards regression models were used to analyse the associations between PA (amount and changes) and all-cause mortality risk. Results During a mean follow-up of 3.7 years, 16 431 (27.3%) deaths occurred. Higher PA levels after dementia diagnosis were associated with a dose-dependent decrease in mortality risk (p for trend <0.001). Maintaining regular PA, compared with remaining inactive, was associated with the lowest mortality risk (HR=0.71, 95% CI 0.65 to 0.79). Sustained engagement in PA of any intensity was associated with decreased mortality risk: light (HR=0.70, 95% CI 0.67 to 0.75), moderate (HR=0.74, 95% CI 0.64 to 0.86) and vigorous PA (HR=0.70, 95% CI 0.61 to 0.79). Initiating any PA intensity after dementia diagnosis was associated with at least 20% reduced mortality risk. These associations were consistent in Alzheimer’s disease. Conclusions Maintaining or initiating regular PA, regardless of intensity, after dementia diagnosis was associated with a reduced risk of all-cause mortality. Lifestyle modifications promoting PA might offer survival benefits for individuals with dementia. No data are available. This study was performed using the National Health Insurance System database in Korea, and the results do not necessarily represent the opinions of the National Health Insurance Corporation. Restrictions apply to the availability of these data, which were used under the licence for this study.

中文翻译：

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痴呆患者身体活动和全因死亡率的变化：使用韩国国家健康保险服务数据库的队列研究


目的 探讨痴呆诊断前后规律体力活动 （PA） 的数量和变化与全因死亡风险之间的关联，以及这些关联是否因 PA 强度 （轻度、中度或剧烈） 而异。方法 这项回顾性队列研究使用了韩国国家健康保险服务数据库的数据，包括 2010 年至 2016 年间新诊断为痴呆的 60 252 例患者，他们在诊断前后接受了健康检查。使用国际身体活动问卷 - 简表评估 PA。多变量 Cox 比例风险回归模型用于分析 PA （数量和变化） 与全因死亡风险之间的关联。结果 在平均 3.7 年的随访期间，发生了 16 431 例 （27.3%） 死亡。痴呆诊断后较高的 PA 水平与死亡风险的剂量依赖性降低相关 （p 趋势 <0.001）。与保持不活动相比，维持常规 PA 与最低的死亡风险相关 （HR=0.71,95% CI 0.65 至 0.79）。持续参与任何强度的 PA 都与死亡风险降低相关：轻度 （HR=0.70,95% CI 0.67 至 0.75）、中度 （HR=0.74,95% CI 0.64 至 0.86） 和剧烈 PA （HR=0.70,95% CI 0.61 至 0.79）。在痴呆诊断后开始任何 PA 强度与死亡风险降低至少 20% 相关。这些关联在阿尔茨海默病中是一致的。结论 在痴呆诊断后，无论强度如何，维持或开始定期 PA 与全因死亡风险降低相关。促进 PA 的生活方式改变可能会为痴呆症患者提供生存益处。没有可用的数据。 本研究是使用韩国国民健康保险系统数据库进行的，结果不一定代表国家健康保险公团的意见。这些数据的可用性受到限制，这些数据是根据本研究的许可使用的。