Kim Lois G, Adamson Joy, Ebrahim Shah
Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK.
Age Ageing. 2013 Nov;42(6):696-701. doi: 10.1093/ageing/aft127. Epub 2013 Sep 29.
many chronic conditions have their roots in modifiable health-related behaviours.
a total of 4,286 women aged 60-79 in the British Women's Heart and Health Study are followed up for incident cardiovascular disease (CVD), arthritis and locomotor disability over 7 years. Self-reported smoking, alcohol consumption, exercise and fruit intake at baseline is also available. Associations between these and each outcome, plus a composite outcome, are investigated in those without prevalent disease at baseline using logistic regression with multiple imputation.
ex-smokers and current smokers showed increased odds of locomotor disability, CVD and the combined outcome. Less regular exercisers had increased odds of all outcomes, particularly locomotor disability. There was no evidence that alcohol or fruit intake was associated with any outcome. Population attributable fractions (PAFs) suggest in addition to the influence of smoking and alcohol, exercise accounts for 9% of incident locomotor disability, 5% of CVD and 4% of arthritis. All four lifestyle factors combined account for 17% of incident locomotor disability and 9% of incident conditions combined.
never smokers and regular exercisers had substantially reduced odds of 7-year disability onset. Low PAFs suggest changes in health-related behaviours in older women would result in only modest reductions in common chronic conditions.
许多慢性疾病都源于可改变的健康相关行为。
在英国女性心脏与健康研究中，对4286名年龄在60 - 79岁的女性进行了为期7年的随访，以观察心血管疾病（CVD）、关节炎和运动功能障碍的发病情况。同时还获取了她们在基线时自我报告的吸烟、饮酒、运动和水果摄入量。在基线时无相关疾病的人群中，采用多重填补的逻辑回归分析这些因素与每种结局以及综合结局之间的关联。
既往吸烟者和当前吸烟者出现运动功能障碍、心血管疾病及综合结局的几率增加。运动较少者出现所有结局的几率增加，尤其是运动功能障碍。没有证据表明饮酒或水果摄入量与任何结局有关。人群归因分数（PAF）表明，除了吸烟和饮酒的影响外，运动导致9%的新发运动功能障碍、5%的心血管疾病和4%的关节炎。所有这四个生活方式因素共同导致17%的新发运动功能障碍和9%的综合发病情况。
从不吸烟者和经常运动者7年残疾发病几率大幅降低。低PAF表明老年女性健康相关行为的改变只会使常见慢性病发病率有适度降低。
