Ensrud Kristine E, Blackwell Terri L, Cauley Jane A, Dam Thuy-Tien L, Cawthon Peggy M, Schousboe John T, Barrett-Connor Elizabeth, Stone Katie L, Bauer Douglas C, Shikany James M, Mackey Dawn C
Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota; Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System, Minneapolis, Minnesota.
J Am Geriatr Soc. 2014 Nov;62(11):2079-87. doi: 10.1111/jgs.13101. Epub 2014 Nov 3.
To examine associations between objective measures of activity level and mortality risk in older men.
Prospective cohort study.
Six U.S. sites.
Men aged 71 and older followed an average of 4.5 years (N = 2,918).
Time awake spent in sedentary behavior (metabolic equivalent (MET) level ≤1.50), light activity (MET level 1.51-2.99), and at least moderate activity (MET level ≥3.00) measured using an activity monitor worn for 5 days or longer and expressed as quartiles. Deaths were confirmed with death certificates; cause of death was adjudicated by review of certificates and records.
During follow-up, 409 (14%) men died. After multivariable adjustment, comparing Q4 with Q1, more time spent in sedentary behavior (Q4 vs Q1, hazard ratio (HR) = 1.51, 95% confidence interval (CI) = 1.10-2.08), less time spent in light activity (Q1 vs Q4, HR = 1.54, 95% CI = 1.06-2.24), and less time spent in at least moderate activity (Q1 vs Q4, HR = 1.56, 95% CI = 1.09-2.25) were similarly associated with greater mortality risk primarily due to higher risks of cardiovascular and noncardiovascular, noncancer death. The association between time spent in sedentary behavior and mortality varied according to time spent at higher activity level. More time spent in sedentary behavior was associated with greater risk of death in men spending 1.2 (median) h/d or more in at least moderate activity (Q4 vs Q1, HR = 2.09, 95% CI = 1.26-3.49) but not in those spending less time (Q4 vs Q1, HR = 1.02, 95% CI = 0.62-1.66) (P = .005 for interaction).
In older men exceeding current guidelines on physical activity, more time spent in sedentary behavior is associated with greater mortality risk.
研究老年男性活动水平的客观测量指标与死亡风险之间的关联。
前瞻性队列研究。
美国六个地点。
71岁及以上男性，平均随访4.5年（N = 2918）。
使用佩戴5天或更长时间的活动监测器测量清醒时久坐行为（代谢当量（MET）水平≤1.50）、轻度活动（MET水平1.51 - 2.99）和至少中度活动（MET水平≥3.00）的时间，并以四分位数表示。通过死亡证明确认死亡；通过审查证明和记录判定死亡原因。
随访期间，409名（14%）男性死亡。多变量调整后，将四分位数4与四分位数1相比，久坐行为时间越长（四分位数4与四分位数1相比，风险比（HR）= 1.51，95%置信区间（CI）= 1.10 - 2.08）、轻度活动时间越少（四分位数1与四分位数4相比，HR = 1.54，95% CI = 1.06 - 2.24）以及至少中度活动时间越少（四分位数1与四分位数4相比，HR = 1.56，95% CI = 1.09 - 2.25），均与更高的死亡风险相似相关，主要是由于心血管疾病以及非心血管、非癌症死亡风险更高。久坐行为时间与死亡率之间的关联因在更高活动水平上花费的时间而异。在每天至少进行中度活动1.2（中位数）小时或更多时间的男性中，久坐行为时间越长与死亡风险越高相关（四分位数4与四分位数1相比，HR = 2.09，95% CI = 1.26 - 3.49），而在花费时间较少的男性中则不然（四分位数4与四分位数1相比，HR = 1.02，95% CI = 0.62 - 1.66）（交互作用P = 0.005）。
在超过当前身体活动指南的老年男性中，久坐行为时间越长与死亡风险越高相关。
