锻炼频率对老年人生活自理能力维持的影响——一项基于社区队列的研究

Impact of exercise frequency on self-care ability maintaining in older adults:a community-based cohort study

目的探讨锻炼频率对老年人生活自理能力维持的影响。方法基于2012-2020年广州市荔湾区南源社区队列的研究,对基线纳入的6905名老年人进行随访,对其生活自理能力进行评分。对纳入分析的5154人采用边际结构时依Cox比例风险回归模型,衡量老年人日常锻炼频率与维持生活自理能力之间的关系。结果过去1年中,有48.58%的研究对象每天锻炼。最后1次随访中,生活不能完全自理的老年人占4.2%,随访中位时间为3.63年。经校正混杂因素,与不锻炼相比,偶尔锻炼和每天锻炼不能维持生活自理能力的风险分别降低了44.9%(HR=0.551,95%CI:0.432~0.701)和39.9%(HR=0.601,95%CI:0.460~0.784)。分层分析发现,无论是偶尔锻炼还是每天锻炼,对于吸烟者而言,都不能有效降低他们无法维持生活自理能力的风险。从不吸烟者偶尔锻炼或每天锻炼能降低不能维持生活自理能力的风险,分别降低了45.8%(HR=0.542,95%CI:0.419~0.702)和39.7%(HR=0.603,95%CI:0.453~0.804)。对于饮酒者而言,无论是偶尔锻炼还是坚持每天锻炼,都不能有效降低他们无法维持生活自理能力的风险。从不饮酒者偶尔锻炼或每天锻炼能降低不能维持生活自理能力的风险,分别降低了45.1%(HR=0.549,95%CI:0.429~0.704)和39.4%(HR=0.606,95%CI:0.459~0.800)。结论老年人可以通过锻炼维持生活自理能力,但饮酒会减弱锻炼维持生活自理能力的效果,建议减少饮酒量或戒酒,并采取科学锻炼方式。

Objective To investigate the impact of exercise frequency on the maintenance of elderly individuals'self-care ability.Methods A cohort study was conducted in Nanyuan Community,Liwan District,Guangzhou,from 2012 to 2020.A total of 6905 elderly individuals were enrolled in the baseline survey and followed up for the evaluation of their self-care ability.Among the 5154 participants included in the analysis,a marginal structural Cox proportional hazards regression model was employed to assess the relationship between daily exercise frequency and the maintenance of self-care ability among the elderly.Results Over the past year,48.58%of study subjects exercised daily.At the last follow-up,4.2%of the elderly were unable to take care of themselves completely,and the median follow-up time was 3.63 years.After adjusting for confounding factors,compared to no exercise,occasional exercise and daily exercise reduced the risk of not maintaining self-care ability by 44.9%(HR=0.551,95%CI:0.432-0.701)and 39.9%(HR=0.601,95%CI:0.460-0.784),respectively.The stratified analysis found that neither occasional nor daily exercise was effective in reducing the risk of smokers not being able to sustain their independence.However,for non-smokers,occasional and daily exercise reduced the risk by 45.8%(HR=0.542,95%CI:0.419-0.702)and 39.7%(HR=0.603,95%CI:0.453-0.804),respectively.For alcohol consumers,neither occasional exercise nor consistent daily exercise can effectively reduce the risk of losing the ability to maintain self-care.However,the risks of not maintaining self-care ability were more significantly reduced by occasional and daily exercise among non-drinkers,with reductions of 45.1%(HR=0.549,95%CI:0.429-0.704)and 39.4%(HR=0.606,95%CI:0.459-0.800),respectively.Conclusions Exercise can help elderly individuals maintain their self-care ability.Alcohol consumption among the elderly can attenuate the positive effects of physical exercise on maintaining self-care ability.It is recommended that elderly individuals reduce or abstain from alcohol consumption and adopt scientific exercise methods.