UCL Department of Primary Care & Population Health, Institute of Epidemiology and Health Care, UCL Medical School, Rowland Hill Street, London, NW3 2PF, UK.
UCL Physical Activity Research Group, London, UK.
Int J Behav Nutr Phys Act. 2018 Feb 7;15(1):14. doi: 10.1186/s12966-017-0642-4.
Maintenance of physical activity (PA) during later life is associated with optimal health; however, the long-term trajectories of PA into old age and their predictors have not been extensively researched using latent class methods. This study aimed to identify trajectories of self-reported PA and their predictors in men transitioning from midlife to old age.
7735 men (aged 40-59 years) recruited in 1978-80 were followed up after 12, 16 and 20 years, reporting PA, health status, lifestyle behaviours and socio-demographic characteristics. Group-based trajectory modelling identified the trajectories of PA and associations with time-stable and time-varying covariates. We considered a range of sociodemographic and health and lifestyle factors as potential covariates.
4952 men (mean baseline age 49.1 ± 5.6 years) providing PA data at ≥3 time points were included in analyses. Three distinct 20-year trajectories were identified: low decreasing (24.6%, n = 1218), light stable (51.1%, n = 2530) and moderate increasing (24.3%, n = 1204). Being older, having a manual occupation, having never married or had children, residing in the midlands or North of England, suffering from a range of health conditions, being a smoker/ex-smoker and never consuming breakfast cereal or alcohol were independently associated with reduced odds of belonging to the moderate increasing trajectory group compared to the low decreasing group. Of the time-varying covariates considered, leaving employment was associated with a decrease in PA in the low decreasing group (β -0.306, p < 0.001) but an increase in the light stable (β 0.324, p < 0.001) and moderate increasing groups (β 0.847, p < 0.001). Developing cardiovascular-related conditions was associated with a decrease in PA in the low decreasing (β -0.408, p < 0.001) and light stable groups (β -0.118, p < 0.001) but no association was observed in the moderate increasing group (β -0.060, p = 0.313).
Three distinct trajectories of PA were identified in men transitioning from midlife to old age, of which nearly a quarter had persistently low levels of PA. Promotion efforts may need to focus attention prior to middle age and consider a number of sociodemographic, health and lifestyle factors to sustain PA into old age. The effects of retirement and development of cardiovascular disease may vary according to PA trajectories.
在晚年保持身体活动（PA）与最佳健康相关；然而，使用潜在类别方法，尚未广泛研究 PA 进入老年的长期轨迹及其预测因素。本研究旨在确定从中年过渡到老年的男性中自我报告的 PA 轨迹及其预测因素。
1978-80 年招募的 7735 名男性（年龄 40-59 岁）在 12、16 和 20 年后进行了随访，报告了 PA、健康状况、生活方式行为和社会人口统计学特征。基于群组的轨迹建模确定了 PA 的轨迹及其与时间稳定和时变协变量的关联。我们考虑了一系列社会人口统计学以及健康和生活方式因素作为潜在的协变量。
在至少 3 个时间点提供 PA 数据的 4952 名男性（平均基线年龄 49.1±5.6 岁）被纳入分析。确定了三个 20 年的轨迹：低下降（24.6%，n=1218）、轻稳定（51.1%，n=2530）和中度增加（24.3%，n=1204）。年龄较大、从事体力劳动、未婚或无子女、居住在英格兰中部或北部、患有多种健康状况、吸烟/戒烟以及从不食用早餐麦片或酒精与属于中度增加轨迹组的可能性降低相关，而不属于低下降组。在所考虑的时变协变量中，离职与低下降组的 PA 下降有关（β-0.306，p<0.001），但与轻稳定（β0.324，p<0.001）和中度增加组（β0.847，p<0.001）有关。心血管相关疾病的发展与低下降组（β-0.408，p<0.001）和轻稳定组（β-0.118，p<0.001）的 PA 下降有关，但在中度增加组中没有观察到关联（β-0.060，p=0.313）。
从中年过渡到老年的男性中确定了三种不同的 PA 轨迹，其中近四分之一的男性 PA 水平持续较低。促进工作可能需要在中年之前集中注意力，并考虑一些社会人口统计学、健康和生活方式因素，以维持老年的 PA。退休和心血管疾病的发展的影响可能因 PA 轨迹而异。
