Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
California Pacific Medical Center, San Francisco, California, USA.
J Gerontol A Biol Sci Med Sci. 2022 Dec 29;77(12):2507-2516. doi: 10.1093/gerona/glac082.
Lower physical activity (PA) is associated with greater perceived fatigability, a person-centered outcome. The association between change in PA and fatigability with advanced age has yet to be established.
Community-dwelling older men (N = 1 113, age = 84.1 ± 3.9 years at Year 14) had free-living PA assessed using SenseWear Armband prospectively at Year 7 (2007-2009) and Year 14 (2014-2016) of Osteoporotic Fractures in Men Study, a longitudinal cohort established in 2000 (baseline). We categorized percent changes in PA into groups (large decline → large increase) for 4 metrics: step count, light intensity PA (LIPA, metabolic equivalents [METs] >1.5 to <3.0), moderate-to-vigorous PA (MVPA, METs ≥ 3.0), and sedentary behavior (SB, METs ≤ 1.5, excluding sleep). Perceived physical and mental fatigability were measured (Year 14) with the Pittsburgh Fatigability Scale (PFS, higher score = greater fatigability; range = 0-50). Associations between each metric of percent changes in PA and fatigability were examined using linear regression, adjusted for demographics, change in health conditions, and Year 7 step count or total PA (METs > 1.5).
Men declined 2 336 ± 2 546 (34%) steps/d, 24 ± 31 (25%) LIPA min/d, 33 ± 58 (19%) MVPA min/d, and increased 40 ± 107 (6%) SB min/d over 7.2 ± 0.7 years. Compared to large decline (% change less than -50%), those that maintained or increased step count had 3-8 points lower PFS Physical scores; those who maintained or increased LIPA and MVPA had 2-3 and 2-4 points lower PFS Physical scores, respectively (all p ≤ .01). Associations were similar, but smaller, for PFS Mental scores.
Older men who maintained or increased PA had lower fatigability, independent of initial PA. Our findings inform the types and doses of PA that should be targeted to reduce fatigability in older adults.
较低的身体活动（PA）与更高的感知疲劳有关，这是一个以人为中心的结果。PA 变化与老年人疲劳之间的关系尚未确定。
本研究纳入了 1113 名居住在社区的老年男性（年龄为 84.1±3.9 岁，于第 14 年进行研究），前瞻性地使用 SenseWear Armband 评估他们的自由活动 PA，研究数据来源于 2000 年建立的纵向队列研究——男性骨质疏松性骨折研究（Osteoporotic Fractures in Men Study，OFMS），该研究于第 7 年（2007-2009 年）和第 14 年（2014-2016 年）收集数据（基线）。我们根据以下 4 个指标将 PA 的百分比变化分为不同的组别（大幅下降→大幅增加）：步数、低强度 PA（LIPA，代谢当量 [METs] >1.5 至 <3.0）、中等到剧烈 PA（MVPA，METs ≥ 3.0）和久坐行为（SB，METs ≤ 1.5，不包括睡眠）。在第 14 年（OFMS 第 14 年），我们使用匹兹堡疲劳量表（PFS，得分越高表示疲劳感越强；范围为 0-50）来测量参与者的身体和精神疲劳感。使用线性回归分析了 PA 百分比变化的每个指标与疲劳感之间的关系，调整了人口统计学因素、健康状况变化以及第 7 年的步数或总 PA（METs > 1.5）。
男性在 7.2±0.7 年的时间内，每天的步数减少了 2336±2546（34%），LIPA 减少了 24±31（25%），MVPA 减少了 33±58（19%），SB 增加了 40±107（6%）。与大幅下降（%变化小于-50%）相比，那些保持或增加步数的人，其 PFS 身体得分低 3-8 分；那些保持或增加 LIPA 和 MVPA 的人，其 PFS 身体得分低 2-3 分和 2-4 分，差异均有统计学意义（所有 p≤0.01）。对于 PFS 心理得分，也有类似但较小的关联。
保持或增加 PA 的老年人疲劳感更低，这与初始 PA 无关。我们的研究结果为确定应针对哪种类型和剂量的 PA 来降低老年人的疲劳感提供了信息。
