重新分配加速度计评估的久坐时间为轻度或中等到剧烈强度的身体活动可降低老年人的虚弱程度：TSHA 研究中的等时替代方法。
Reallocating Accelerometer-Assessed Sedentary Time to Light or Moderate- to Vigorous-Intensity Physical Activity Reduces Frailty Levels in Older Adults: An Isotemporal Substitution Approach in the TSHA Study.
机构信息
GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Castilla-La Mancha, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Comunidad de Madrid, Spain.
Department of Exercise Sciences, University of Auckland, Auckland, New Zealand.
出版信息
J Am Med Dir Assoc. 2018 Feb;19(2):185.e1-185.e6. doi: 10.1016/j.jamda.2017.11.003. Epub 2017 Dec 18.
INTRODUCTION
The effects of replacing sedentary time with light or moderate- to vigorous-intensity physical activity on frailty are not well known.
AIM
To examine the mutually independent associations of sedentary time (ST), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) with frailty status in older adults.
METHODS
A total of 628 people aged ≥65 years from the Toledo Study of Healthy Aging (TSHA) participated in this cross-sectional study. Frailty was measured using the Frailty Trait Scale. Hip-worn accelerometers were used to capture objective measurements of ST, LPA, and MVPA. Linear regression and isotemporal substitution analyses were used to examine associations of ST, LPA, and MVPA with frailty status. Analyses were also stratified by comorbidity.
RESULTS
In single and partition models, LPA and MVPA were negatively associated with frailty. Time in sedentary behavior was not associated with frailty in these models. In the isotemporal substitution models, replacing 30 minutes/d of ST with MVPA was associated with a decrease in frailty [β -2.460; 95% confidence interval (CI): -3.782, -1.139]. In contrast, replacing ST with LPA was not associated with favorable effects on this outcome. However, when the models were stratified by comorbidity, replacing ST with MVPA had the greatest effect on frailty in both the comorbidity (β -2.556; 95% CI: -4.451, -0.661) and the no comorbidity group (β -2.535; 95% CI: -4.343, -0.726). Moreover, the favorable effects of LPA in people with comorbidities was found when replacing 30 minutes/d of ST with LPA (β -0.568; 95% CI: -1.050, -0.086).
CONCLUSIONS
Substituting ST with MVPA is associated with theoretical positive effects on frailty. People with comorbidity may also benefit from replacing ST with LPA, which may have important clinical implications in order to decrease the levels of physical frailty.
简介
久坐时间被轻或中高强度体力活动替代对衰弱的影响尚不清楚。
目的
研究久坐时间（ST）、低强度体力活动（LPA）和中高强度体力活动（MVPA）与老年人衰弱状态的相互独立关联。
方法
共有 628 名年龄≥65 岁的托莱多健康老龄化研究（TSHA）参与者参与了这项横断面研究。使用衰弱特征量表测量衰弱。佩戴在臀部的加速度计用于捕获 ST、LPA 和 MVPA 的客观测量。线性回归和等时替代分析用于研究 ST、LPA 和 MVPA 与衰弱状态的关联。分析还按合并症进行分层。
结果
在单变量和分区模型中，LPA 和 MVPA 与衰弱呈负相关。在这些模型中，久坐行为时间与衰弱无关。在等时替代模型中，用 MVPA 替代 30 分钟/天的 ST 与衰弱程度降低相关[β-2.460；95%置信区间（CI）：-3.782，-1.139]。相比之下，用 LPA 替代 ST 与改善该结局无关。然而，当按合并症分层模型时，用 MVPA 替代 ST 在合并症（β-2.556；95% CI：-4.451，-0.661）和无合并症组（β-2.535；95% CI：-4.343，-0.726）中对衰弱的影响最大。此外，在有合并症的人群中，用 LPA 替代 30 分钟/天的 ST 时，发现 LPA 的有利效果（β-0.568；95% CI：-1.050，-0.086）。
结论
用 MVPA 替代 ST 与衰弱理论上的积极影响有关。有合并症的人也可能受益于用 LPA 替代 ST，这可能对降低身体衰弱水平具有重要的临床意义。
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