Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.
BMC Med. 2013 Mar 19;11:75. doi: 10.1186/1741-7015-11-75.
Retirement represents a major transitional life stage in middle to older age. Changes in physical activity typically accompany this transition, which has significant consequences for health and well-being. The aim of this systematic review was to evaluate the evidence for the effect of interventions to promote physical activity in adults aged 55 to 70 years, focusing on studies that reported long-term effectiveness. This systematic review adheres to a registered protocol (PROSPERO CRD42011001459).
Randomized controlled trials of interventions to promote physical activity behavior with a mean/median sample age of 55 to 70 years, published between 2000 and 2010, were identified. Only trials reporting the long-term effect (≥ 12 months) on objective or self-reported physical activity behavior were included. Trials reporting physiological proxy measures of physical activity were excluded. Meta-analyses were conducted when trials provided sufficient data and sensitivity analyses were conducted to identify potential confounding effects of trials of poor methodological quality or with attrition rates ≥ 30%.
Of 17,859 publications identified, 32 were included which reported on 21 individual trials. The majority of interventions were multimodal and provided physical activity and lifestyle counselling. Interventions to promote physical activity were effective at 12 months (standardized mean difference (SMD) = 1.08, 95% confidence interval (CI) = 0.16 to 1.99, pedometer step-count, approximating to an increase of 2,197 steps per day; SMD = 0.19, 95% CI = 0.10 to 0.28, self-reported physical activity duration outcome), but not at 24 months based on a small subset of trials. There was no evidence for a relationship between intervention effectiveness and mode of delivery or number of intervention contacts; however, interventions which involved individually tailoring with personalized activity goals or provision of information about local opportunities in the environment may be more effective.
Interventions in adults aged 55 to 70 years led to long term improvements in physical activity at 12 months; however, maintenance beyond this is unclear. Identified physical activity improvements are likely to have substantial health benefits in reducing the risk of age-related illnesses. These findings have important implications for community-based public health interventions in and around the retirement transition.
退休代表了中年到老年的一个重要过渡生活阶段。身体活动的变化通常伴随着这一转变，这对健康和幸福有重大影响。本系统评价的目的是评估促进 55 至 70 岁成年人身体活动的干预措施的证据，重点是报告长期有效性的研究。本系统评价遵循已注册的方案（PROSPERO CRD42011001459）。
确定了 2000 年至 2010 年间发表的、以 55 至 70 岁为平均/中位数样本年龄的促进身体活动行为的随机对照试验。仅纳入报告了对客观或自我报告身体活动行为的长期影响（≥12 个月）的试验。排除报告身体活动生理替代指标的试验。当试验提供足够的数据时，进行了荟萃分析，并进行了敏感性分析，以确定方法质量差或失效率≥30%的试验的潜在混杂效应。
在确定的 17859 篇文献中，有 32 篇文献报道了 21 项单独的试验。大多数干预措施是多模式的，提供身体活动和生活方式咨询。促进身体活动的干预措施在 12 个月时有效（标准化均数差（SMD）=1.08，95%置信区间（CI）=0.16 至 1.99，计步器步数，约增加 2197 步/天；SMD=0.19，95%CI=0.10 至 0.28，自我报告的身体活动持续时间结局），但根据一小部分试验，24 个月时无效。干预效果与交付方式或干预接触次数之间没有关系的证据；然而，涉及个人定制个性化活动目标或提供环境中当地机会信息的干预措施可能更有效。
55 至 70 岁成年人的干预措施导致身体活动在 12 个月时的长期改善；然而，在此之后的维持情况尚不清楚。确定的身体活动改善可能对减少与年龄相关疾病的风险有重大的健康益处。这些发现对退休过渡期内和周围的社区为基础的公共卫生干预措施具有重要意义。
