Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland, USA.
J Gerontol A Biol Sci Med Sci. 2022 Sep 1;77(9):1882-1889. doi: 10.1093/gerona/glab278.
Self-reported low physical activity is a defining feature of phenotypic frailty but does not adequately capture physical activity performed throughout the day. This study examined associations between accelerometer-derived patterns of routine daily physical activity and frailty.
Wrist accelerometer and frailty data from 638 participants (mean age 77 [SD = 5.5] years; 44% women) were used to derive 5 physical activity metrics: active minutes/day, sedentary minutes/day, total activity counts/day, activity fragmentation (reciprocal of the average active bout length), and sedentary fragmentation (reciprocal of the average sedentary bout length). Robust, prefrail, and frail statuses were identified using the physical frailty phenotype defined as having 0, 1-2, or ≥3 of the following criterion: weight loss, exhaustion, slowness, self-reported low activity, and weakness. Frailty was collapsed into not frail (robust and prefrail) and frail, and each frailty criteria was dichotomized. Multiple logistic regression was used to model each accelerometer metric. Separate frailty criteria and interactions with age and sex were also examined.
With higher amounts and intensity of daily activity (more active minutes, fewer sedentary minutes, higher activity counts) and lower activity fragmentation, the odds of frailty were lower compared to robust/prefrail states (p < .02 for all). For interactions, only an age by sedentary fragmentation interaction on the odds of frailty was observed (p = .01). For each separate criteria, accelerometer metrics were associated with odds of slowness, low activity, and weakness.
Less favorable patterns of objectively measured daily physical activity are associated with frailty and the components of slowness, low self-reported activity, and weakness.
自我报告的低体力活动是表型虚弱的一个特征，但不能充分捕捉全天进行的体力活动。本研究探讨了加速计得出的日常体力活动模式与虚弱之间的关联。
使用来自 638 名参与者（平均年龄 77 [SD = 5.5] 岁；44%为女性）的腕部加速度计和虚弱数据，得出 5 项体力活动指标：每天活跃分钟数、每天久坐分钟数、每天总活动计数、活动碎片化（平均活跃段长度的倒数）和久坐碎片化（平均久坐段长度的倒数）。使用身体虚弱表型定义识别稳健、虚弱前期和虚弱状态，该定义是指具有以下 0、1-2 或 ≥3 个标准的个体：体重减轻、疲惫、行动缓慢、自我报告的低活动量和虚弱。将虚弱状态分为不虚弱（稳健和虚弱前期）和虚弱，并将每个虚弱标准分为两类。使用多项逻辑回归模型来模拟每个加速度计指标。还检查了单独的虚弱标准以及与年龄和性别之间的交互作用。
与稳健/虚弱前期状态相比，每日活动量和强度较高（更多活跃分钟数、更少久坐分钟数、更高活动计数）以及活动碎片化程度较低时，虚弱的可能性较低（所有指标 p <.02）。对于交互作用，仅观察到年龄与久坐碎片化之间的交互作用对虚弱的可能性有影响（p =.01）。对于每个单独的标准，加速度计指标与行动缓慢、低自我报告活动量和虚弱的可能性有关。
客观测量的日常体力活动模式较差与虚弱以及行动缓慢、低自我报告活动量和虚弱的组成部分有关。
