仪器测量的久坐行为和身体活动与社区居住的老年人的死亡率相关：系统评价、荟萃分析和荟萃回归分析。
Instrumented measures of sedentary behaviour and physical activity are associated with mortality in community-dwelling older adults: A systematic review, meta-analysis and meta-regression analysis.
机构信息
Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
Department of Internal Medicine, Amstelland Hospital, Laan van de Helende Meesters 8, 1186 AM, Amstelveen, The Netherlands; Department of Internal Medicine, Amsterdam University Medical Center, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
出版信息
Ageing Res Rev. 2020 Aug;61:101061. doi: 10.1016/j.arr.2020.101061. Epub 2020 Apr 30.
BACKGROUND
Sedentary behaviour (SB) and physical activity (PA) can be objectively assessed with inertial sensors to describe bodily movement. Higher SB and lower PA is associated with higher chronological age and negative health outcomes. This study aimed to quantify the association between instrumented measures of SB (i-SB) and PA (i-PA) and mortality in community-dwelling older adults, to subsequently compare the quantitative effect sizes and to determine the dose-response relationships.
METHODS
An electronic search in six databases from inception to 27th of June 2019 was conducted. All articles reporting on i-SB or i-PA and mortality in community-dwelling older adults aged 60 years or older were considered eligible. A meta-analysis was conducted for the association between i-SB and i-PA and mortality expressed in Hazard Ratios (HR) and 95% Confidence Intervals (95% CI). A meta-regression analysis was performed to determine the dose-response relationship between i-SB and steps per day and mortality.
RESULTS
Twelve prospective articles representing eleven cohorts, reporting data of 38,141 participants were included. In total 2502 (6.4%) participants died during follow-up (2.0 to 9.8 years). Comparing the most sedentary with the least sedentary groups of participants resulted in a pooled HR of 2.44 (95% CI 1.82-3.25). Comparing the least active with the most active groups of participants resulted in a pooled HR of 1.93 (95% CI 1.39-2.69); 2.66 (95% CI 2.11-3.35); 3.43 (95% CI 2.61-4.52), and 3.09 (95% CI 2.33-4.11) for light, moderate-to-vigorous-, total PA and steps per day, respectively. Meta-regression analyses showed clear dose-response relationships between i-SB and steps per day and mortality risk.
CONCLUSION
Both i-SB and i-PA are significantly associated with mortality in community-dwelling older adults, showing the largest effect size for total physical activity. Dose-response relationships could be observed for i-SB and steps per day.
背景
久坐行为（SB）和身体活动（PA）可以通过惯性传感器进行客观评估，以描述身体运动。较高的 SB 和较低的 PA 与较高的年龄和负面健康结果有关。本研究旨在量化仪器测量的 SB（i-SB）和 PA（i-PA）与社区居住的老年人死亡率之间的关联，随后比较定量效应大小，并确定剂量-反应关系。
方法
从开始到 2019 年 6 月 27 日，在六个数据库中进行了电子搜索。所有报告社区居住的 60 岁或以上老年人的 i-SB 或 i-PA 与死亡率相关的文章均被认为符合条件。使用危险比（HR）和 95%置信区间（95%CI）表达 i-SB 和 i-PA 与死亡率之间的关联进行荟萃分析。进行了荟萃回归分析，以确定 i-SB 与每天步数之间的剂量-反应关系与死亡率。
结果
共纳入 12 项前瞻性研究，代表 11 个队列，报告了 38141 名参与者的数据。共有 2502 名（6.4%）参与者在随访期间死亡（2.0-9.8 年）。将最久坐的参与者与最活跃的参与者进行比较，得出的合并 HR 为 2.44（95%CI 1.82-3.25）。将最不活跃的参与者与最活跃的参与者进行比较，得出的合并 HR 分别为 1.93（95%CI 1.39-2.69）；2.66（95%CI 2.11-3.35）；3.43（95%CI 2.61-4.52）和 3.09（95%CI 2.33-4.11），分别为轻、中至剧烈、总 PA 和每天步数。荟萃回归分析显示，i-SB 与每天步数和死亡率风险之间存在明显的剂量-反应关系。
结论
i-SB 和 i-PA 与社区居住的老年人死亡率显著相关，总身体活动的效应最大。可以观察到 i-SB 和每天步数之间的剂量-反应关系。
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