健康风险评估与咨询对老年人身体活动的影响：一项实用随机试验。

Effects of health risk assessment and counselling on physical activity in older people: A pragmatic randomised trial.

作者信息

Herghelegiu Anna Marie, Moser André, Prada Gabriel Ioan, Born Stephan, Wilhelm Matthias, Stuck Andreas E

机构信息

National Institute of Gerontology and Geriatrics "Ana Aslan", Bucharest, Romania.

University of Medicine and Pharmacy "Carol Davila", Geriatrics and Gerontology Department, Bucharest, Romania.

出版信息

PLoS One. 2017 Jul 20;12(7):e0181371. doi: 10.1371/journal.pone.0181371. eCollection 2017.

DOI:10.1371/journal.pone.0181371

PMID:28727796

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5519086/

Abstract

BACKGROUND

Interventions to increase physical activity (PA) among older community-dwelling adults may be enhanced by using multidimensional health risk assessment (HRA) as a basis for PA counselling.

METHODS

The study was conducted among nondisabled but mostly frail persons 65 years of age and older at an ambulatory geriatric clinic in Bucharest, Romania. From May to July 2014, 200 participants were randomly allocated to intervention and control groups. Intervention group participants completed an initial HRA questionnaire and then had monthly counselling sessions with a geriatrician over a period of six months that were aimed at increasing low or maintaining higher PA. Counselling also addressed the older persons' concomitant health risks and problems. The primary outcome was PA at six months (November 2014 to February 2015) evaluated with the International Physical Activity Questionnaire.

RESULTS

At baseline, PA levels were similar in intervention and control groups (median 1089.0, and 1053.0 MET [metabolic equivalent of task] minutes per week, interquartile ranges 606.0-1401.7, and 544.5-1512.7 MET minutes per week, respectively). Persons in the intervention group had an average of 11.2 concomitant health problems and risks (e.g., pain, depressive mood, hypertension). At six months, PA increased in the intervention group by a median of 180.0 MET minutes per week (95% confidence interval (CI) 43.4-316.6, p = 0.01) to 1248.8 MET minutes per week. In the control group, PA decreased by a median of 346.5 MET minutes per week (95% CI 178.4-514.6, p<0.001) to 693.0 MET minutes per week due to a seasonal effect, resulting in a difference of 420.0 MET minutes per week (95% CI 212.7-627.3, p< 0.001) between groups.

CONCLUSION

The use of HRA to inform individualized PA counselling is a promising method for achieving improvements in PA, and ultimately health and longevity among large groups of community-dwelling older persons.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number: ISRCTN11166046.

摘要

背景

通过使用多维健康风险评估（HRA）作为体力活动咨询的基础，可能会加强针对社区居住的老年人增加体力活动（PA）的干预措施。

方法

该研究在罗马尼亚布加勒斯特一家门诊老年诊所中65岁及以上无残疾但大多身体虚弱的人群中进行。2014年5月至7月，200名参与者被随机分配到干预组和对照组。干预组参与者完成了一份初始HRA问卷，然后在六个月的时间里每月与一名老年病医生进行一次咨询，旨在增加低水平体力活动或维持较高水平的体力活动。咨询还涉及老年人伴随的健康风险和问题。主要结局是在六个月时（2014年11月至2015年2月）使用国际体力活动问卷评估的体力活动情况。

结果

在基线时，干预组和对照组的体力活动水平相似（中位数分别为每周1089.0和1053.0代谢当量[MET]分钟，四分位间距分别为每周606.0 - 1401.7和544.5 - 1512.7 MET分钟）。干预组的人平均有11.2种伴随的健康问题和风险（如疼痛、抑郁情绪、高血压）。在六个月时，干预组的体力活动增加，中位数为每周180.0 MET分钟（95%置信区间[CI] 43.4 - 316.6，p = 0.01），达到每周1248.8 MET分钟。在对照组中，由于季节效应，体力活动中位数每周减少346.5 MET分钟（95% CI 178.4 - 514.6，p < 0.001），降至每周693.0 MET分钟，导致两组之间每周相差420.0 MET分钟（95% CI 212.7 - 627.3，p < 0.001）。