Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain.
Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Santiago, Chile.
Sports Med. 2020 Jun;50(6):1095-1106. doi: 10.1007/s40279-020-01259-y.
Physical exercise is beneficial to reduce the risk of several conditions associated with advanced age, but to our knowledge, no previous study has examined the association of long-term exercise interventions (≥ 1 year) with the occurrence of dropouts due to health issues and mortality, or the effectiveness of physical exercise versus usual primary care interventions on health-related outcomes in older adults (≥ 65 years old).
To analyze the safety and effectiveness of long-term exercise interventions in older adults.
We conducted a systematic review with meta-analysis examining the association of long-term exercise interventions (≥ 1 year) with dropouts from the corresponding study due to health issues and mortality (primary endpoint), and the effects of these interventions on health-related outcomes (falls and fall-associated injuries, fractures, physical function, quality of life, and cognition) (secondary endpoints).
Ninety-three RCTs and six secondary studies met the inclusion criteria and were included in the analyses (n = 28,523 participants, mean age 74.2 years). No differences were found between the exercise and control groups for the risk of dropouts due to health issues (RR = 1.05, 95% CI 0.95-1.17) or mortality (RR = 0.93, 95% CI 0.83-1.04), although a lower mortality risk was observed in the former group when separately analyzing clinical populations (RR = 0.67, 95% CI 0.48-0.95). Exercise significantly reduced the number of falls and fall-associated injuries, and improved physical function and cognition. These results seemed independent of participants' baseline characteristics (age, physical function, and cognitive status) and exercise frequency.
Long-term exercise training does not overall influence the risk of dropouts due to health issues or mortality in older adults, and results in a reduced mortality risk in clinical populations. Moreover, exercise reduces the number of falls and fall-associated injuries, and improves physical function and cognition in this population.
体育锻炼有益于降低多种与老年相关疾病的风险，但据我们所知，尚无研究探讨长期运动干预（≥1 年）与因健康问题和死亡导致的退出率以及体育锻炼与常规初级保健干预对老年人（≥65 岁）健康相关结局的有效性之间的关系。
分析长期运动干预对老年人的安全性和有效性。
我们进行了一项系统综述和荟萃分析，评估了长期运动干预（≥1 年）与因健康问题退出相应研究的关系（主要终点），以及这些干预对健康相关结局（跌倒和跌倒相关损伤、骨折、身体功能、生活质量和认知）的影响（次要终点）。
93 项 RCT 和 6 项二次研究符合纳入标准并纳入分析（n=28523 名参与者，平均年龄 74.2 岁）。在因健康问题而退出的风险方面，运动组与对照组之间没有差异（RR=1.05，95%CI 0.95-1.17）或死亡率（RR=0.93，95%CI 0.83-1.04），尽管在单独分析临床人群时，前者的死亡率风险较低（RR=0.67，95%CI 0.48-0.95）。运动显著减少了跌倒和跌倒相关损伤的发生，并改善了身体功能和认知。这些结果似乎独立于参与者的基线特征（年龄、身体功能和认知状态）和运动频率。
长期运动训练总体上不会影响老年人因健康问题或死亡导致的退出风险，并且在临床人群中降低了死亡率风险。此外，运动减少了老年人跌倒和跌倒相关损伤的发生，改善了身体功能和认知。
