GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.
CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
J Bone Miner Res. 2020 Jul;35(7):1236-1245. doi: 10.1002/jbmr.3988. Epub 2020 Mar 17.
Frailty is associated with poor bone health and osteoporosis, and physical activity (PA) is one of the best treatments for both pathologies in older adults. Nonetheless, because daily time is limited, how the time is distributed during the waking hours is critical. The waking hours are spent according to different movement behaviors: sedentary behaviors (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). The aim of this study was to use compositional data analyses to examine the effects of the change in movement behaviors on bone health during aging in older people, related to the changes in their frailty levels. We analyzed 227 older people aged 65 to 94 (125 women and 102 men) over a 4-year period. Movement behaviors were assessed using accelerometry. Both bone mineral density (BMD) and bone mineral content (BMC) were determined using bone densitometry. The Frailty Trait Scale was used to divide the sample by frailty level evolution during aging. The R statistical system was used for the compositional data analysis and, in addition, all models were adjusted for several covariates. The changes in the distribution of all movement behaviors within a waking hour period were significantly associated with spine and femoral neck BMD changes in the subgroup with a positive change in frailty level and spine BMC in the subgroup with no change in frailty level (p ≤ .05). Likewise, MVPA relative to the change in other movement behaviors was also associated in both subgroups with higher BMD and BMC, respectively, in the same body areas (p ≤ .05). No significant associations were found in the negative change in frailty level subgroup. Older people who achieved a positive change in frailty level during a 4-year period showed higher BMD changes compared to those with no changes or increases in their frailty level. Therefore, increasing MVPA relative to the change in the other movement behaviors during a 4-year period could perhaps produce bone health improvements in the elderly that do not worsen their frailty level. © 2020 American Society for Bone and Mineral Research.
衰弱与骨骼健康和骨质疏松症有关，体力活动（PA）是治疗老年人这两种疾病的最佳方法之一。尽管如此，由于每天的时间是有限的，因此在清醒时间内如何分配时间至关重要。清醒时间是根据不同的运动行为来分配的：久坐行为（SB）、低强度体力活动（LPA）和中高强度体力活动（MVPA）。本研究的目的是使用成分数据分析来研究在老年人中，随着其衰弱水平的变化，运动行为的变化对骨骼健康的影响。我们分析了 227 名年龄在 65 至 94 岁的老年人（125 名女性和 102 名男性），为期 4 年。使用加速度计评估运动行为。使用骨密度仪测定骨矿物质密度（BMD）和骨矿物质含量（BMC）。使用衰弱特征量表根据衰老过程中衰弱水平的变化将样本分组。R 统计系统用于成分数据分析，此外，所有模型均针对多个协变量进行调整。在一个清醒时间内，所有运动行为的分布变化与脊柱和股骨颈 BMD 在衰弱水平呈正变化的亚组中以及脊柱 BMC 在衰弱水平无变化的亚组中发生变化显著相关（p≤0.05）。同样，MVPA 相对于其他运动行为的变化也与两个亚组中相同身体部位的较高 BMD 和 BMC 相关（p≤0.05）。在衰弱水平呈负变化的亚组中未发现显著相关性。在 4 年内达到衰弱水平正变化的老年人与那些衰弱水平没有变化或增加的老年人相比，BMD 变化更高。因此，与其他运动行为的变化相比，在 4 年内增加 MVPA 可能会改善老年人的骨骼健康，而不会使他们的衰弱水平恶化。© 2020 美国骨骼与矿物质研究协会。
