Hirvensalo M, Rantanen T, Heikkinen E
Finnish Centre for Interdisciplinary Gerontology, Department of Physical Education, University of Jyväskylä.
J Am Geriatr Soc. 2000 May;48(5):493-8. doi: 10.1111/j.1532-5415.2000.tb04994.x.
In older people, mobility impairments and physical inactivity are risk factors for further disability and death. We studied the interaction of physical activity and mobility impairment as a predictor of dependence and mortality.
A population-based, prospective study. The data were collected in structured interviews in the year 1988 and 8 years later in the year 1996 as part of the Evergreen Project.
Subjects were 1109 independently living, at baseline 65- to 84-year-old people in the city of Jyvaskyla, in central Finland.
Participants were ranked into four groups: (1) Intact mobility and physically active (Mobile-Active), (2) Intact mobility and sedentary (Mobile-Sedentary), (3) Impaired mobility and physically active (Impaired-Active), and (4) Impaired mobility and sedentary (Impaired-Sedentary). The confounders adjusted for in the models included age, marital status, education, chronic conditions, smoking, and physical exercise earlier in life.
In men and women, the relative risk of death was two times greater in Impaired-Active and three times greater in Impaired-Sedentary groups than the risk of death in Mobile-Active groups. However, the risk of death did not differ between Mobile-Active and Mobile-Sedentary groups. The odds ratio for dependency (95% confidence interval) in Impaired-Sedentary men was 5.21 (1.44-18.70) and in Impaired-Sedentary women was 2.92 (1.52-5.60) compared to Mobile-Active groups. The risk of dependence did not differ significantly between Mobile-Active, Mobile-Sedentary, and Impaired-Active groups.
Mobility impairments predicted mortality and dependence. However, among people with impaired mobility, physical activity was associated with lower risks, whereas the risk did not differ according to activity level among those with intact mobility. Despite of their overall greater risk, mobility-impaired people may be able to prevent further disability and mortality by physical exercise.
在老年人中，行动不便和缺乏身体活动是导致进一步残疾和死亡的风险因素。我们研究了身体活动与行动不便之间的相互作用，将其作为依赖和死亡的预测因素。
一项基于人群的前瞻性研究。作为常青项目的一部分，数据于1988年通过结构化访谈收集，并在8年后的1996年再次收集。
研究对象为芬兰中部于韦斯屈莱市1109名独立生活的65至84岁老年人，均为基线数据。
参与者被分为四组：（1）行动能力正常且身体活跃（行动正常-活跃组），（2）行动能力正常但久坐不动（行动正常-久坐组），（3）行动不便但身体活跃（行动不便-活跃组），以及（4）行动不便且久坐不动（行动不便-久坐组）。模型中调整的混杂因素包括年龄、婚姻状况、教育程度、慢性病、吸烟以及早年的体育锻炼情况。
在男性和女性中，行动不便-活跃组的死亡相对风险是行动正常-活跃组的两倍，行动不便-久坐组的死亡相对风险是行动正常-活跃组的三倍。然而，行动正常-活跃组和行动正常-久坐组之间的死亡风险没有差异。与行动正常-活跃组相比，行动不便-久坐组男性的依赖比值比（95%置信区间）为5.21（1.44 - 18.70），行动不便-久坐组女性的依赖比值比为2.92（1.52 - 5.60）。行动正常-活跃组、行动正常-久坐组和行动不便-活跃组之间的依赖风险没有显著差异。
行动不便预示着死亡和依赖。然而，在行动不便的人群中，身体活动与较低风险相关，而在行动能力正常的人群中，风险并未因活动水平而有所不同。尽管行动不便的人群总体风险更高，但他们可能通过体育锻炼预防进一步的残疾和死亡。
