社区居住老年人的行走节奏与死亡率
Walking cadence and mortality among community-dwelling older adults.
作者信息
Brown Justin C, Harhay Michael O, Harhay Meera N
机构信息
Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, PA, USA,
出版信息
J Gen Intern Med. 2014 Sep;29(9):1263-9. doi: 10.1007/s11606-014-2926-6. Epub 2014 Jun 17.
BACKGROUND
Older adults are encouraged to walk ≥100 steps∙minute(-1) for moderate-intensity physical activity (i.e., brisk walking). It is unknown if the ability to walk ≥100 steps∙minute(-1) predicts mortality.
OBJECTIVE
To determine if the ability to walk ≥100 steps∙minute(-1) predicts mortality among older adults.
DESIGN, SETTING, AND PATIENTS: A population-based cohort study among 5,000 older adults from the Third National Health and Nutrition Survey (NHANES III; 1988-1994). Vital status and cause of death were collected through December 31, 2006. Median follow-up was 13.4 years. Average participant age was 70.6 years.
MEASUREMENTS
Walking cadence (steps∙minute(-1)) was calculated using a timed 2.4-m walk. Walking cadence was dichotomized at 100 steps∙minute(-1) (≥100 steps∙minute(-1) versus <100 steps∙minute(-1)) to demarcate the lower threshold of absolutely defined moderate-intensity physical activity. Walking cadence was also analyzed as a continuous variable. Predicted survival was compared between walking cadence and gait speed. The primary outcome was all-cause mortality. Secondary outcomes included cardiovascular-specific and cancer-specific mortality and mortality from other causes.
RESULTS
Among 5,000 participants, 3,039 (61 %) walked ≥100 steps∙minute(-1). During follow-up, 3,171 subjects died. In multivariable-adjusted analysis, ability to walk ≥100 steps∙minute(-1) predicted a 21 % reduction in all-cause mortality (hazard ratio [HR], 0.79; 95 % confidence interval [95 % CI], 0.71-0.89, p < 0.001). Each ten-step increase in walking cadence predicted a 4 % reduction in all-cause mortality (HR, 0.96, [0.94-0.98], p < 0.001). In secondary analyses, ability to walk ≥100 steps∙minute(-1) predicted reductions in cardiovascular-specific mortality (HR, 0.79 [0.67-0.92], p = 0.002), cancer-specific mortality (HR, 0.76 [0.58-0.99], p = 0.050), and mortality from other causes (HR, 0.82 [0.68-0.97], p = 0.025). Predicted survival, adjusted for age and sex, was not different using walking cadence versus gait speed.
LIMITATIONS
Walking cadence was a cross-sectional measurement.
CONCLUSIONS
The ability to walk ≥100 steps∙minute(-1) predicts a reduction in mortality among a sample of community-dwelling older adults.
背景
鼓励老年人以每分钟≥100步的速度行走，进行中等强度的体力活动（即快走）。每分钟行走≥100步的能力是否能预测死亡率尚不清楚。
目的
确定每分钟行走≥100步的能力是否能预测老年人的死亡率。
设计、地点和患者：一项基于人群的队列研究，研究对象为来自第三次全国健康与营养调查（NHANES III；1988 - 1994年）的5000名老年人。通过2006年12月31日收集生命状态和死亡原因。中位随访时间为13.4年。参与者的平均年龄为70.6岁。
测量
使用定时2.4米步行计算步行节奏（每分钟步数）。将步行节奏在每分钟100步处进行二分法划分（≥100步/分钟与<100步/分钟），以界定绝对定义的中等强度体力活动的下限阈值。步行节奏也作为连续变量进行分析。比较步行节奏和步速之间的预测生存率。主要结局是全因死亡率。次要结局包括心血管疾病特异性和癌症特异性死亡率以及其他原因导致的死亡率。
结果
在5000名参与者中，3039名（61%）每分钟行走≥100步。在随访期间，3171名受试者死亡。在多变量调整分析中，每分钟行走≥100步的能力预测全因死亡率降低21%（风险比[HR]，0.79；95%置信区间[95%CI]，0.71 - 0.89，p<0.001）。步行节奏每增加十步，预测全因死亡率降低4%（HR，0.96，[0.94 - 0.98]），p<0.001）。在次要分析中，每分钟行走≥100步的能力预测心血管疾病特异性死亡率降低（HR，0.79 [0.67 - 0.92]，p = 0.002），癌症特异性死亡率降低（HR，0.76 [0.58 - 0.99]，p = 0.050），以及其他原因导致的死亡率降低（HR，0.82 [0.68 - 0.97]，p = 0.025）。根据年龄和性别调整后的预测生存率，使用步行节奏与步速并无差异。
局限性
步行节奏是一项横断面测量。
结论
每分钟行走≥100步的能力可预测社区居住老年人样本中的死亡率降低。
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