Chakravarty Eliza F, Hubert Helen B, Lingala Vijaya B, Fries James F
Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, USA.
Arch Intern Med. 2008 Aug 11;168(15):1638-46. doi: 10.1001/archinte.168.15.1638.
Exercise has been shown to improve many health outcomes and well-being of people of all ages. Long-term studies in older adults are needed to confirm disability and survival benefits of exercise.
Annual self-administered questionnaires were sent to 538 members of a nationwide running club and 423 healthy controls from northern California who were 50 years and older beginning in 1984. Data included running and exercise frequency, body mass index, and disability assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI; scored from 0 [no difficulty] to 3 [unable to perform]) through 2005. A total of 284 runners and 156 controls completed the 21-year follow-up. Causes of death through 2003 were ascertained using the National Death Index. Multivariate regression techniques compared groups on disability and mortality.
At baseline, runners were younger, leaner, and less likely to smoke compared with controls. The mean (SD) HAQ-DI score was higher for controls than for runners at all time points and increased with age in both groups, but to a lesser degree in runners (0.17 [0.34]) than in controls (0.36 [0.55]) (P < .001). Multivariate analyses showed that runners had a significantly lower risk of an HAQ-DI score of 0.5 (hazard ratio, 0.62; 95% confidence interval, 0.46-0.84). At 19 years, 15% of runners had died compared with 34% of controls. After adjustment for covariates, runners demonstrated a survival benefit (hazard ratio, 0.61; 95% confidence interval, 0.45-0.82). Disability and survival curves continued to diverge between groups after the 21-year follow-up as participants approached their ninth decade of life.
Vigorous exercise (running) at middle and older ages is associated with reduced disability in later life and a notable survival advantage.
运动已被证明能改善所有年龄段人群的多种健康状况和幸福感。需要对老年人进行长期研究以证实运动对残疾和生存的益处。
从1984年开始，每年向全国跑步俱乐部的538名成员和来自北加利福尼亚的423名50岁及以上的健康对照者发送自我管理问卷。数据包括跑步和运动频率、体重指数以及通过健康评估问卷残疾指数（HAQ - DI；评分从0[无困难]到3[无法进行]）评估的残疾情况，直至2005年。共有284名跑步者和156名对照者完成了21年的随访。通过国家死亡指数确定截至2003年的死亡原因。采用多变量回归技术比较两组在残疾和死亡率方面的情况。
在基线时，与对照组相比，跑步者更年轻、更瘦且吸烟可能性更低。在所有时间点，对照组的平均（标准差）HAQ - DI评分均高于跑步者，且两组评分均随年龄增加，但跑步者的增加幅度（0.17[0.34]）小于对照组（0.36[0.55]）（P <.001）。多变量分析显示，跑步者HAQ - DI评分达到0.5的风险显著更低（风险比，0.62；95%置信区间，0.46 - 0.84）。19年后，15%的跑步者死亡，而对照组为34%。在对协变量进行调整后，跑步者显示出生存获益（风险比，0.61；95%置信区间，0.45 - 0.82）。在21年随访后，随着参与者接近九十岁，两组之间的残疾和生存曲线继续出现差异。
中老年时期的剧烈运动（跑步）与晚年残疾减少和显著的生存优势相关。
