论文部分内容阅读
背景:人们对老年人体力活动变化与全因死亡率之间的关系还知之甚少。有关80岁及80岁以上老年人体力活动、健康、全因死亡率间关系的信息少之又少。本文在一项80—85岁老年人死亡率的18年随访研究的初始阶段,探讨体力活动作为全因死亡率的预测因子在5年间的持久性和改变状况,以及健康作为中介关系。方法:在超过5年的时间段内(始于1989-1990,终于1994-1995),用始于1989年的“常青藤计划”数据,根据体力活动水平自我报告变化将被调查对象分为4组:保持活跃组(RA,对照组)、变为不活跃组(CI)、保持不活跃组(RI)、变为活跃组(CA),连续18年(1994-2012)追踪其死亡率。用年龄、性别、酒精摄入、慢性疾病和10 m走路测试等不同协变量COX模型分析体力活动水平变化与死亡率间的关系。结果:对比RA组,调整年龄、性别和慢性病因素后,体力活动水平在基线与随访期之间降低的老年人全因死亡率较高(风险比(HR)=2.09;95%CI:1.63-2.69)。RI组显示全因死亡率最高(HR=2.16;95%CI:1.59-2.93)。CA组与RA组比较,全因死亡风险无显著差别(HR=1.51;95%CI:0.95-2.38)。与RA组相比,如果增加步远大于10 m为协变量,全因死亡风险只在CI组中有显著差异(HR=1.37;95%CI:1.00-1.87)。结论:体力活动水平的持久性及改变与死亡率相关。这种相关性主要由健康状况来解释。需要随机对照研究证明可否通过保持或提高老年人体力活动水平来延长老年人寿命。
Background: There is little known about the relationship between changes in physical activity and all-cause mortality in the elderly. There is very little information on the relationship between physical activity, health and all-cause mortality in people aged 80 and over. In this initial phase of an 18-year follow-up study of 80-85 year olds mortality rates, this article explores the persistence and change in physical activity as a predictor of all-cause mortality over a five-year period, and health as an intermediary. METHODS: Over a 5-year period (from 1989-1990, finally 1994-1995), self-reported changes based on physical activity levels were categorized according to the Ivy League plan data from 1989 4 groups: the active group (RA, control group), inactive group (CI), inactive group (RI) and active group (CA) . The relationship between changes in physical activity level and mortality was analyzed using different covariate COX models such as age, sex, alcohol intake, chronic diseases and 10 m walk test. RESULTS: All-cause mortality was higher in the elderly with reduced levels of physical activity between baseline and follow-up after adjustment for age, gender, and chronic disease factors (hazard ratio (HR) = 2.09; 95% CI: 1.63- 2.69). The RI group showed the highest all-cause mortality (HR = 2.16; 95% CI: 1.59-2.93). There was no significant difference in risk of all-cause mortality between the CA and RA groups (HR = 1.51; 95% CI: 0.95-2.38). The risk of all-cause mortality was only significantly different in the CI group (HR = 1.37; 95% CI: 1.00-1.87) if the increase was greater than 10 m as a covariate compared with the RA group. Conclusions: The persistence and changes in physical activity levels are associated with mortality. This correlation is mainly explained by the state of health. Randomized controlled trials are needed to demonstrate that life expectancy of the elderly can be extended by maintaining or improving physical activity in the elderly.