Department of Health and Exercise Sciences, Wake Forest University, Winston-Salem, North Carolina.
Department of Biostatistical and Data Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
J Am Geriatr Soc. 2020 Jul;68(7):1476-1483. doi: 10.1111/jgs.16386. Epub 2020 Mar 20.
To examine the relationship between time spent in light physical activity (LPA) and in moderate to vigorous physical activity (MVPA) and the pattern of accumulation on the risk for major mobility disability (MMD) in a large multicenter study of physical activity (PA) and aging, the Lifestyle Interventions and Independence for Elders (LIFE) study.
Data were collected from individuals randomized to a PA intervention as part of the LIFE study, an eight-center single-blind randomized clinical trial conducted between February 2010 and December 2013.
Lifestyle Interventions and Independence for Elders Study PARTICIPANTS: Older adult participants (78.4 years; N = 507) at risk for MMD.
All older adults included in these analyses were randomized to a structured PA intervention that included two center-based plus three to four home-based exercise sessions per week with a primary goal of walking for 150 minutes weekly. Participants attended the intervention for 2.5 years on average.
MMD was defined as the inability to complete a 400-m walk within 15 minutes and without assistance. Physical function was assessed via the Short Physical Performance Battery (SPPB). Actigraph accelerometers were used to quantify amount and variability in LPA and MVPA.
In an adjusted Cox proportional hazards regression, we identified a significant interaction (P = .017) between SPPB score and LPA amount and variability such that more LPA was associated with a reduced risk for MMD among those with higher initial function, as was lower variability (eg, via distributing LPA across the day). The SPPB × MVPA interaction was significant (P = .04), such that more MVPA was associated with lower MMD risk among those with lower function. Finally, greater MVPA variability was associated with lower risk for MMD.
A prescription of PA for older adults should account for key factors such as physical function and emphasize both amount and pattern of accumulation of PA from across the intensity continuum. J Am Geriatr Soc 68:1476-1483, 2020.
在一项大型多中心体力活动（PA）和老龄化研究——生活方式干预和老年人独立（LIFE）研究中，考察轻体力活动（LPA）和中等到剧烈体力活动（MVPA）时间与主要移动性残疾（MMD）风险累积模式之间的关系。
数据来自作为 LIFE 研究一部分随机分配至 PA 干预的个体，LIFE 研究是一项于 2010 年 2 月至 2013 年 12 月进行的、八中心单盲随机临床试验。
生活方式干预和老年人独立研究
有发生 MMD 风险的老年参与者（78.4 岁；N=507）。
所有纳入这些分析的老年人都被随机分配至一种结构化 PA 干预，该干预包括每周两次中心基础加三到四次家庭基础锻炼，主要目标是每周步行 150 分钟。参与者平均参加干预 2.5 年。
MMD 定义为无法在 15 分钟内不借助帮助完成 400 米步行。身体功能通过简短体能表现电池（SPPB）进行评估。Actigraph 加速度计用于量化 LPA 和 MVPA 的量和变异性。
在调整后的 Cox 比例风险回归中，我们发现 SPPB 评分与 LPA 量和变异性之间存在显著交互作用（P=.017），即对于初始功能较高者，LPA 量越大，发生 MMD 的风险越低，变异性越低（例如，通过在一天内分布 LPA）也是如此。SPPB×MVPA 交互作用显著（P=.04），即对于功能较低者，MVPA 量越大，MMD 风险越低。最后，MVPA 变异性越大，MMD 风险越低。
为老年人开具 PA 处方时应考虑关键因素，如身体功能，并强调整个强度连续体中 PA 的量和积累模式。美国老年学会杂志 68：1476-1483，2020。
