Table 1_Primitive reflexes as behavioral biomarkers of cognitive aging: associations with physical activity and resilience—a pilot study.docx

IntroductionPrimitive reflexes (PRs) are brainstem-mediated automatic responses that typically disappear in early life, but may reappear in older age, which may be associated with neurodegenerative processes. But the presence of PRs in cognitively healthy adults has not yet been sufficiently explored. The relationship between PRs and cognitive functioning (COG) may be influenced by modifiable factors such as physical activity (PA) and psychological resilience. This cross-sectional observational pilot study aimed to investigate the mediating and moderating role of physical activity and resilience in the association between primitive reflexes and cognitive functioning in older adults.
MethodsA total of 30 older adults (mean age 73.4 ± 6.9 years; 80% female) living in residential care facilities were assessed. PRs were evaluated using standardized neurological protocols, COG was measured with the Mini-Mental State Examination, PA with the Global Physical Activity Questionnaire, and resilience with the Connor–Davidson Resilience Scale. Moderation and mediation models were tested using Hayes’ PROCESS macro, controlling for age and BMI.
ResultsA higher number of primitive reflexes was strongly associated with lower cognitive functioning [COG (r = −0.904, p < 0.001)]. Physical activity showed a significant mediating effect in this association, indicating that more active older adults exhibited better cognitive performance despite the presence of primitive reflexes. Resilience, although correlated with both cognition and physical activity, did not show a mediating or moderating effect.
DiscussionThese findings highlight primitive reflexes as potential behavioral biomarkers of cognitive aging, and underscore the importance of physical activity as a protective factor that may buffer against neurocognitive decline.

引言
原始反射（Primitive Reflexes，PRs）是由脑干介导的自主反射，通常在幼年时期消退，但在老年阶段可能重现，该现象或与神经退行性过程相关。目前针对认知健康成年人中原始反射的存在情况仍缺乏充分探索。原始反射与认知功能（cognitive functioning，COG）之间的关联，可能受到身体活动（physical activity，PA）、心理弹性（psychological resilience）等可调节因素的影响。本横断面观察性预实验旨在探讨身体活动与心理弹性在老年人群原始反射与认知功能关联中的中介与调节作用。

方法

共纳入30名居住于养老机构的老年受试者（平均年龄73.4±6.9岁；女性占比80%）并完成相关评估。采用标准化神经学方案评估原始反射，以简易精神状态检查表（Mini-Mental State Examination）评估认知功能，以全球身体活动问卷（Global Physical Activity Questionnaire）评估身体活动水平，以康纳-戴维森心理弹性量表（Connor–Davidson Resilience Scale）评估心理弹性。采用Hayes的PROCESS宏程序构建调节与中介模型，并控制年龄与身体质量指数（Body Mass Index，BMI）。

结果

原始反射检出数量越多，认知功能水平越低，二者呈显著负相关（r=-0.904，p<0.001）。身体活动在该关联中呈现显著的中介效应，提示即便存在原始反射，身体活动水平更高的老年受试者仍可表现出更优的认知功能。尽管心理弹性与认知功能及身体活动均存在相关性，但未表现出中介或调节效应。

讨论

本研究结果表明，原始反射可作为认知衰老的潜在行为生物标志物，同时凸显了身体活动作为可缓冲神经认知衰退的保护因素的重要性。