生活方式干预减轻体重可改善老年人活动能力。
Weight Loss through Lifestyle Intervention Improves Mobility in Older Adults.
机构信息
Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pennsylvania, USA.
Department of Psychiatry, University of Pittsburgh, Pennsylvania, USA.
出版信息
Gerontologist. 2022 Jul 15;62(6):931-941. doi: 10.1093/geront/gnab048.
BACKGROUND AND OBJECTIVES
The high prevalence of overweight or obesity in older adults is a public health concern because obesity affects health, including the risk of mobility disability.
RESEARCH DESIGN AND METHODS
The Mobility and Vitality Lifestyle Program, delivered by community health workers (CHWs), enrolled 303 community-dwelling adults to assess the impact of a 32-session behavioral weight management intervention. Participants completed the program at 26 sites led by 22 CHWs. Participation was limited to people aged 60-75 who had a body mass index (BMI) of 27-45 kg/m2. The primary outcome was the performance on the Short Physical Performance Battery (SPPB) over 12 months.
RESULTS
Participants were aged 67.7 (SD 4.1) and mostly female (87%); 22.7% were racial minorities. The mean (SD) BMI at baseline was 34.7 (4.7). Participants attended a median of 24 of 32 sessions; 240 (80.3%) completed the 9- or 13-month outcome assessment. Median weight loss in the sample was 5% of baseline body weight. SPPB total scores improved by +0.31 units (p < .006), gait speed by +0.04 m/s (p < .0001), and time to complete chair stands by -0.95 s (p < .0001). Weight loss of at least 5% was associated with a gain of +0.73 in SPPB scores. Increases in activity (by self-report or device) were not independently associated with SPPB outcomes but did reduce the effect of weight loss.
DISCUSSION AND IMPLICATIONS
Promoting weight management in a community group setting may be an effective strategy for reducing the risk of disability in older adults.
背景和目的
老年人超重或肥胖的高发率是一个公共卫生关注点，因为肥胖会影响健康，包括行动不便的风险。
研究设计和方法
由社区卫生工作者（CHW）提供的“移动和活力生活方式计划”招募了 303 名居住在社区的成年人，以评估 32 节行为体重管理干预的影响。参与者在由 22 名 CHW 领导的 26 个地点完成该计划。参与者仅限于年龄在 60-75 岁之间、体重指数（BMI）为 27-45kg/m2 的人群。主要结局是在 12 个月内进行短体适能表现电池（SPPB）的表现。
结果
参与者的年龄为 67.7（SD 4.1），大多数为女性（87%）；22.7%为少数民族。基线时的平均（SD）BMI 为 34.7（4.7）。参与者中位数参加了 32 节课中的 24 节；240（80.3%）完成了 9 或 13 个月的结局评估。样本中的中位数体重减轻了基线体重的 5%。SPPB 总分提高了 0.31 个单位（p <.006），步态速度提高了 0.04m/s（p <.0001），完成椅子站立的时间减少了 0.95s（p <.0001）。体重减轻至少 5%与 SPPB 评分增加 0.73 相关。通过自我报告或设备增加活动量与 SPPB 结局无独立关联，但确实降低了体重减轻的影响。
讨论与启示
在社区群体环境中促进体重管理可能是降低老年人残疾风险的有效策略。
Zotero 插件