From the Department of Occupational and Environmental Health (X.L., S.L., X.M., H.G., Y.Z., X.Z., M.H., K.Y.), Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan; and the Department of Cardiovascular Diseases (H.Y.), Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China.
Neurology. 2022 Jul 18;99(3):e296-e303. doi: 10.1212/WNL.0000000000200555.
To investigate the association of change in leisure-time physical activity (LTPA) occurring during the postretirement period with incident stroke.
The current study enrolled 12,644 retired workers from the Dongfeng-Tongji cohort from April to October 2013. The change in LTPA was categorized as follows, according to whether the LTPA time met the WHO recommended minimum (at least 150 minutes per week): (1) stayed inactive at both surveys; (2) stayed inactive at the 2008 survey but became active at the 2013 survey; (3) stayed active at the 2008 survey but became inactive at the 2013 survey; (4) stayed active at both surveys. We used multivariable-adjusted Cox proportional hazards regression models to examine the association between change in LTPA and the risk of incident stroke.
During 70,437 person-years of follow-up, we documented 549 incident stroke cases, including 434 incident ischemic stroke cases and 115 incident hemorrhagic stroke (HS) cases. Compared with participants who stayed active at both the 2008 and 2013 surveys, those who were active at the 2008 survey but became inactive at the 2013 survey had significantly higher risks of incident total stroke (hazard ratio [HR] 1.30, 95% CI 1.03, 1.65) and HS (HR 2.34, 95% CI 1.51, 3.63). When stratified by body mass index (BMI) categories, a significant elevated risk of total stroke was seen among overweight participants who stayed active at the 2008 survey but became inactive at the 2013 survey (HR 1.65, 95% CI 1.20, 2.27). The risk of incident stroke decreased with increasing LTPA levels between the 2 surveys (HR of per 150 min/wk increase of LTPA: HR 0.97, 95% CI 0.94, 1.00). In addition, we found that compared with participants who maintained their BMI and stayed active at both the 2008 and 2013 surveys, those who were inactive at both points or who became inactive had higher risks of stroke (HR 2.13, 95% CI 1.09, 4.15; HR 1.50, 95% CI 1.07, 2.08, respectively).
Among Chinese older adults, increasing LTPA levels during the postretirement period was associated with a lower risk of incident stroke. Retired individuals should be encouraged to participate in LTPA more frequently to lessen future risk of incident stroke.
研究退休后期间休闲时间体力活动（LTPA）变化与卒中事件的相关性。
本研究纳入了 2013 年 4 月至 10 月期间来自东风-同济队列的 12644 名退休工人。根据是否满足世界卫生组织（WHO）推荐的最低运动量（每周至少 150 分钟），将 LTPA 的变化分为以下几类：（1）两次调查均不活跃；（2）2008 年调查时不活跃，但 2013 年调查时活跃；（3）2008 年调查时活跃，但 2013 年调查时不活跃；（4）两次调查均活跃。我们使用多变量调整的 Cox 比例风险回归模型来检验 LTPA 变化与卒中事件风险之间的关系。
在 70437 人年的随访期间，我们记录了 549 例卒中事件，包括 434 例缺血性卒中和 115 例出血性卒（HS）。与两次调查均活跃的参与者相比，那些在 2008 年调查时活跃但在 2013 年调查时不活跃的参与者，总卒中（风险比 [HR] 1.30，95%可信区间 [CI] 1.03，1.65）和 HS（HR 2.34，95% CI 1.51，3.63）的风险显著升高。当按体重指数（BMI）类别分层时，超重参与者在 2008 年调查时活跃但在 2013 年调查时不活跃，其总卒中的风险显著升高（HR 1.65，95% CI 1.20，2.27）。两次调查之间 LTPA 水平的增加与卒中事件风险的降低相关（每增加 150 分钟/周的 LTPA，HR 0.97，95% CI 0.94，1.00）。此外，我们发现与那些保持 BMI 并在 2008 年和 2013 年两次调查均活跃的参与者相比，那些在两个时间点都不活跃或变得不活跃的参与者卒中风险更高（HR 2.13，95% CI 1.09，4.15；HR 1.50，95% CI 1.07，2.08）。
在中国老年人中，退休后期间 LTPA 水平的增加与卒中事件的风险降低相关。应鼓励退休人员更频繁地参与 LTPA，以降低未来卒中事件的风险。
