Research, Innovation and Teaching Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Spain.
J Gerontol A Biol Sci Med Sci. 2018 Aug 10;73(9):1272-1279. doi: 10.1093/gerona/glx121.
This study sought to determine the association between levels of physical activity and mobility difficulties and time to death while accounting for the effect of several confounders. We also examined the possible interaction between them and how various daily-life mobility difficulties could predict all-cause mortality.
A nationally representative sample of 2,074 noninstitutionalized adults aged 60 years and older was analyzed. Vital status over a 3-year follow-up period was ascertained through national registers or by asking participants' relatives. Kaplan-Meier survival curves were stratified by levels of physical activity and mobility difficulties. Unadjusted and adjusted Cox proportional hazards regression models (by age, gender, marital status, years of education, multimorbidity, tobacco and alcohol consumption, depression, and memory function) were calculated, and interactions between the predictors and the covariates were explored.
There was a dose-gradient effect of physical activity on time to death, with high levels associated with a 51% lower risk of dying, compared with moderate physical activity. Each unit increase in mobility functioning was associated with a 2% drop in mortality. Difficulties in standing for long periods, getting where one wants to go or extending arms to reach objects, were also found to be strong predictors of all-cause mortality.
Our results confirm the importance of older adults practicing moderate-to-vigorous physical activity. The assessment of self-reported difficulties in daily-life mobility activities, such as standing for long periods or not being able to move around, could be used in health settings as a screening for mortality risk.
本研究旨在确定体力活动水平与行动困难程度与死亡时间之间的关联，同时考虑到多种混杂因素的影响。我们还检查了它们之间可能存在的相互作用，以及各种日常生活中的行动困难如何预测全因死亡率。
对 2074 名年龄在 60 岁及以上、非机构化的成年人进行了全国代表性样本分析。通过国家登记册或询问参与者的亲属，确定了 3 年随访期间的生存状态。根据体力活动和行动困难程度对 Kaplan-Meier 生存曲线进行分层。计算了未经调整和调整后的 Cox 比例风险回归模型（按年龄、性别、婚姻状况、受教育年限、多种合并症、吸烟和饮酒、抑郁和记忆功能），并探讨了预测因子和协变量之间的相互作用。
体力活动与死亡时间之间存在剂量梯度效应，与中度体力活动相比，高水平体力活动与死亡风险降低 51%相关。行动功能每增加一个单位，死亡率就会降低 2%。长时间站立、无法到达想去的地方或伸展手臂去够取物体等行动困难也被发现是全因死亡率的强有力预测因素。
我们的结果证实了老年人进行适度至剧烈体力活动的重要性。在健康场所，评估日常生活中行动困难的自我报告，如长时间站立或无法移动，可用于筛查死亡率风险。
