Martinez-Gomez David, Guallar-Castillón Pilar, Hallal Pedro C, Lopez-Garcia Esther, Rodríguez-Artalejo Fernando
1Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education, Universidad Autónoma de Madrid, Madrid, SPAIN; 2Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz; CIBER of Epidemiology and Public Health, Madrid, SPAIN; and 3Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, BRAZIL.
Med Sci Sports Exerc. 2015 Mar;47(3):568-74. doi: 10.1249/MSS.0000000000000435.
High cardiorespiratory fitness (CRF) is strongly associated with longer life among older adults. CRF can be assessed by exercise-based methods, which are not feasible in most clinical settings. Thus, nonexercise algorithms to estimate CRF have been developed, but whether they predict mortality in older adults is uncertain.
A cohort of 1470 men and 1460 women, representative of the Spanish population age ≥60 yr, was established in 2000/2001 and followed up prospectively through 2011. At baseline, nonexercise CRF was estimated with the sex-specific algorithms developed by Jackson et al. Analyses were performed with Cox regression and adjusted for the main confounders.
During an average follow-up of 9.4 yr, 570 (38.8%) deaths occurred in men and 295 (20.2%) in women. Among men, no association was observed between nonexercise CRF and all-cause mortality. Compared with women in the lowest quartile of CRF, the hazard ratio (95% confidence interval) for all-cause death was 0.81 (0.62-1.06) in the second quartile, 0.68 (0.48-0.95) in the third quartile, and 0.56 (0.36-0.87) in the highest quartile (P for trend = 0.004). Results held regardless of age, body mass index, waist circumference, HR, subjective health, functional limitations, and disease status.
Higher nonexercise CRF was related to lower risk of death in older women but not in men. Because previous research does not support clear sex-specific association, further research is required to assess whether nonexercise CRF predicts mortality in older adults or new algorithms should be developed for this population, with special attention to older men.
在老年人中，高心肺适能（CRF）与更长的寿命密切相关。CRF可通过基于运动的方法进行评估，但在大多数临床环境中并不可行。因此，已经开发出非运动算法来估计CRF，但它们是否能预测老年人的死亡率尚不确定。
2000/2001年建立了一个由1470名男性和1460名女性组成的队列，代表年龄≥60岁的西班牙人群，并对其进行前瞻性随访直至2011年。在基线时，使用Jackson等人开发的性别特异性算法估计非运动CRF。采用Cox回归进行分析，并对主要混杂因素进行调整。
在平均9.4年的随访期间，男性中有570人（38.8%）死亡，女性中有295人（20.2%）死亡。在男性中，未观察到非运动CRF与全因死亡率之间的关联。与CRF最低四分位数的女性相比，第二四分位数的全因死亡风险比（95%置信区间）为0.81（0.62 - 1.06），第三四分位数为0.68（0.48 - 0.95），最高四分位数为0.56（0.36 - 0.87）（趋势P值 = 0.004）。无论年龄、体重指数、腰围心率、主观健康状况、功能受限情况和疾病状态如何，结果均成立。
较高的非运动CRF与老年女性较低的死亡风险相关，但与老年男性无关。由于先前的研究不支持明确的性别特异性关联，因此需要进一步研究以评估非运动CRF是否能预测老年人的死亡率，或者是否应为该人群开发新的算法，尤其要关注老年男性。
