From the School of Allied Health, Ageing Research Centre (S.H.), Health Research Institute, University of Limerick, Ireland.
Graduate Entry Medical School (J.F.F.), Health Research Institute, University of Limerick, Ireland.
Stroke. 2020 May;51(5):1388-1395. doi: 10.1161/STROKEAHA.119.028064. Epub 2020 Apr 17.
Background and Purpose- Stroke incidence in younger and middle-aged people is growing. Despite this, its associations in this subset of the stroke population are unknown, and prevention strategies are not tailored to meet their needs. This study examined the association between self-reported walking pace and incident stroke. Methods- Data from the UK Biobank were used in a prospective population-based study. Three hundred and sixty-three thousand, one hundred and thirty-seven participants aged 37 to 73 years (52% women) were recruited. The associations of self-reported walking pace with stroke incidence over follow-up were investigated using Cox proportional-hazard models. Results- Among 363,137 participants, 2705 (0.7%) participants developed a fatal or nonfatal stroke event over the mean follow-up period of 6.1 years (interquartile range, 5.4-6.7). Slow walking pace was associated with a higher hazard for stroke incidence (hazard ratio [HR], 1.45 [95% CI, 1.26-1.66]; <0.0001). Stroke incidence was not associated with walking pace among people <65 years of age. However, slow walking pace was associated with a higher risk of stroke among participants aged ≥65 years (HR, 1.42 [95% CI, 1.17-1.72]; <0.0001). A higher risk for stroke was observed on those with middle (HR, 1.28 [95% CI, 1.01-1.63]; =0.039) and higher (HR, 1.29 [95% CI, 1.05-1.69]; =0.012) deprivation levels but not in the least deprived individuals. Similarly, overweight (HR, 1.30 [95% CI, 1.04-1.63]; =0.019) and obese (HR, 1.33 [95% CI, 1.09-1.63]; =0.004) but not normal-weight individuals had a higher risk of stroke incidence. Conclusions- Slow walking pace was associated with a higher risk of stroke among participants over 64 years of age in this population-based cohort study. The addition of the measurement of self-reported walking pace to primary care or public health clinical consultations may be a useful screening tool for stroke risk.
背景与目的-年轻人和中年人中风的发病率正在上升。尽管如此,在这部分中风人群中,其相关性尚不清楚,预防策略也没有针对他们的需求进行调整。本研究探讨了自我报告的步行速度与中风事件的相关性。
方法-该研究使用英国生物库的数据进行了一项前瞻性的基于人群的研究。共招募了 363137 名年龄在 37 至 73 岁之间(52%为女性)的参与者。使用 Cox 比例风险模型研究了自我报告的步行速度与随访期间中风发生率之间的关系。
结果-在 363137 名参与者中,2705 名(0.7%)参与者在平均 6.1 年(四分位距,5.4-6.7)的随访期间发生了致命或非致命性中风事件。缓慢的步行速度与中风发病率的风险增加相关(风险比[HR],1.45[95%CI,1.26-1.66];<0.0001)。在年龄<65 岁的人群中,步行速度与中风发生率无关。然而,在年龄≥65 岁的参与者中,缓慢的步行速度与更高的中风风险相关(HR,1.42[95%CI,1.17-1.72];<0.0001)。在中(HR,1.28[95%CI,1.01-1.63];=0.039)和较高(HR,1.29[95%CI,1.05-1.69];=0.012)剥夺水平的个体中观察到更高的中风风险,但在最不贫困的个体中则没有。同样,超重(HR,1.30[95%CI,1.04-1.63];=0.019)和肥胖(HR,1.33[95%CI,1.09-1.63];=0.004)但非正常体重的个体中风发病率也更高。
结论-在这项基于人群的队列研究中,年龄在 64 岁以上的参与者中,缓慢的步行速度与中风风险增加相关。将自我报告的步行速度测量添加到初级保健或公共卫生临床咨询中,可能是一种有用的中风风险筛查工具。