可衡量身体活动与心血管事件的关联在行动不便的老年人中：LIFE（生活方式干预和老年人独立）研究。
Association of Accelerometry-Measured Physical Activity and Cardiovascular Events in Mobility-Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study.
机构信息
University of Florida College of Medicine, Gainesville, FL.
Wake Forest School of Medicine, Winston-Salem, NC.
出版信息
J Am Heart Assoc. 2017 Dec 2;6(12):e007215. doi: 10.1161/JAHA.117.007215.
BACKGROUND
Data are sparse regarding the value of physical activity (PA) surveillance among older adults-particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study.
METHODS AND RESULTS
Cardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home-based activity data were collected by hip-worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84-0.96; =0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65-0.89 [=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow-up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85-0.96 [=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63-0.90 [=0.002]) were significantly associated with lower cardiovascular event rates.
CONCLUSIONS
Objective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data.
CLINICAL TRIAL REGISTRATION
URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500.
背景
关于体力活动（PA）监测在老年人中的价值的数据很少——尤其是在那些行动受限的老年人中。本研究的目的是检验 LIFE（生活方式干预和老年人独立）研究中，通过客观测量的日常 PA 与老年人心血管事件发生率之间的纵向关联。
方法和结果
通过医疗记录审查来裁定心血管事件，并在分析中控制心血管风险因素。基线时，通过佩戴在臀部的加速度计收集基于家庭的活动数据，并在随机分组后 6、12 和 24 个月时进行测量，以评估参与者被分配到体力活动或健康教育干预组后的情况。LIFE 研究参与者（n=1590；年龄 78.9±5.2[标准差]岁；67.2%为女性）基于活动数据，每天每多走 500 步，发生后续心血管事件的几率降低 11%（风险比，0.89；95%置信区间，0.84-0.96；=0.001）。此外，基线时，每 30 分钟进行≥500 计数/分钟的活动（风险比，0.75；置信区间，0.65-0.89[=0.001]）也与心血管事件发生率降低相关。在整个随访期间（6、12 和 24 个月），每天的步数（每 500 步；风险比，0.90，置信区间，0.85-0.96[=0.001]）和活动时间（≥500 计数/分钟，每 30 分钟；风险比，0.76；置信区间，0.63-0.90[=0.002]）都与心血管事件发生率降低显著相关。
结论
通过加速度计对体力活动进行客观测量，与活动能力受限的老年人（短体适能电池评分>10 分）的心血管事件相关，这既可以通过基线数据，也可以通过纵向数据进行评估。
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