老年人体力活动与死亡的关联研究

Association between physical activity and mortality among the elderly

目的探讨老年人体力活动与死亡风险的关系,为指导老年人保持适量的体力活动提供依据。方法采用回顾性队列研究方法,通过美国国立卫生研究院-美国退休人员协会饮食与健康研究数据库收集50~71岁老年人的基本信息、每周体力活动项目和活动时间等资料;以全因死亡为结局指标,控制人口学、饮食和疾病等因素,采用限制性立方样条模型和多因素Cox比例风险回归模型分析体力活动时间、活动量及不同强度组合模式与全因死亡的关联。结果收集266072人资料,年龄为(70.11±5.36)岁,其中男性155244人,占58.35%;女性110828人,占41.65%。截至2011年12月31日随访结束,266072人中全因死亡36006例。体力活动时间M(QR)为14.00(14.00)h/周,体力活动量M(QR)为53.00(54.71)MET-h/周。限制性立方样条结果显示,体力活动达到15.0 h/周或50.0 MET-h/周前,全因死亡风险下降较快;但随着体力活动继续增加,全因死亡风险下降趋势变缓(均P<0.05)。多因素Cox比例风险回归分析结果显示,与无体力活动者相比,体力活动时间为0.1~<15.0 h/周、15.0~<29.5 h/周、≥29.5 h/周者(HR=0.502、0.386、0.368)或体力活动量为0.1~<50.0 MET-h/周、50.0~<110.8 MET-h/周、≥110.8 MET-h/周者(HR=0.511、0.379、0.354)的全因死亡风险较低;轻度(0.1~<5.0 h/周)、中度(≥5.0 h/周)和重度(≥1.3 h/周)体力活动组合模式的全因死亡风险较低(HR=0.320)。结论适量的体力活动与死亡风险降低有关,推荐老年人每周体力活动15.0 h或50.0 MET-h并且结合不同强度。

Objective To investigate the association between physical activity and the risk of mortality,so as to provide the basis for guiding the elderly to maintain appropriate levels of physical activity.Methods A retrospective cohort study was adopted.Basic information,weekly physical activity items and duration of the elderly aged 50-71 years old was collected from the National Institutes of Health-American Association of Retired Persons Diet and Health Study da⁃tabase.With all-cause mortality risk as the main outcome indicator,controlling for demographic,dietary and disease fac⁃tors,the association between the duration,metabolic equivalent and intensity of physical activity and all-cause mortality risk was analyzed using restricted cubic spline and multivariable Cox proportional risk regression model.Results A to⁃tal of 266072 participants were included,with an mean age of(70.11±5.36)years old.There were 155244 males(58.35%)and 110828 females(41.65%),with a total of 36006 deaths by December 31,2011.The median duration of physical activity was 14.00(interquartile range,14.00)h/week and the median metabolic equivalents was 53.00(inter⁃quartile range,54.71)MET-h/week.Restricted cubic spline analysis indicated that the risk of all-cause mortality de⁃clined rapidly within the physical activity range of 0 to 15.0 h/week or 50.0 MET-h/week,but with the continuing in⁃crease in physical activity,the decline in the risk of all-cause mortality slowed down(all P<0.05).Multivariable Cox proportional risk regression analysis showed that compared with participants with no physical activity,participants with the duration of 0.1-<15.0 h/week,15.0-<29.5 h/week,≥29.5 h/week(HR=0.502,0.386 and 0.368),or the metabolic equivalent of 0.1-<50.0 MET-h/week,50.0-<110.8 MET-h/week and≥110.8 MET-h/week(HR=0.511,0.379 and 0.354)were associated with a reduced risk of all-cause mortality.The combination of mild(0.1-<5.0 h/week),moderate(≥5.0 h/week)and vigorous(≥1.3 h/week)activities had a lower risk of all-cause mortality(HR=0.320).Conclusion Moderate physical activity is associated with a reduced risk of mortality,and it is recommended to do 15.0 h or 50.0 MET-h of physical activity per week in combination with different intensities.