Salinas-Rodríguez Aarón, Manrique-Espinoza Betty, Palazuelos-González Rosa, Rivera-Almaraz Ana, Jáuregui Alejandra
Center for Evaluation and Surveys Research, National Institute of Public Health, Av. Universidad #655. Colonia Santa María Ahuacatitlan ZC, 62100, Cuernavaca, Mor, Mexico.
Center for Research in Nutrition and Health, National Institute of Public Health, Av. Universidad #655. Colonia Santa María Ahuacatitlan ZC, 62100, Cuernavaca, Mor, Mexico.
Eur Rev Aging Phys Act. 2022 Apr 29;19(1):13. doi: 10.1186/s11556-022-00291-3.
Physical activity (PA) and sedentary behavior (SB) are not stable conditions but change over time and among individuals, and both could have deleterious effects on health-related outcomes among older adults. This study aimed to identify the longitudinal trajectories of PA and SB and estimate their association with quality of life, disability, and all-cause mortality in a national sample of older Mexican adults.
Data comes from three waves of the WHO Study on global AGEing and adult health (SAGE) in Mexico (2009, 2014, 2017). In total, 3209 older adults ages 50 and above were included. PA and SB were determined by using the Global Physical Activity Questionnaire (GPAQ). Disability was measured using the WHO Disability Assessment Schedule (WHODAS 2.0), quality of life using the WHOQOL (WHO Quality of Life) instrument, and all-cause mortality using a verbal autopsy. We used growth mixture modeling (GMM) to investigate the longitudinal trajectories of PA and SB. Three-level linear mixed effect models were used to estimate the associations of PA and SB with quality of life and disability and the Cox model for the association with all-cause mortality.
Three longitudinal trajectories of PA and SB were found: low-PA-decreasers, moderate-PA-decreasers, and high-PA-decreasers for PA; and low-maintainers, steep-decreasers, and steep-increasers for SB. Decreased quality of life, increased disability, and all-cause mortality were all consistently associated with worse PA and SB trajectories.
Our results highlight the need for health policies and prevention strategies that promote PA and limit SB in middle-aged adults. Further studies should consider these activities/behaviors as exposures that vary throughout life and work to identify vulnerable groups of older adults for whom physical activation interventions and programs would be most impactful.
身体活动（PA）和久坐行为（SB）并非稳定不变的状态，而是会随时间和个体发生变化，并且二者都可能对老年人的健康相关结局产生有害影响。本研究旨在确定墨西哥老年成年人全国样本中PA和SB的纵向轨迹，并评估它们与生活质量、残疾及全因死亡率之间的关联。
数据来自墨西哥进行的世界卫生组织全球老龄化与成人健康研究（SAGE）的三轮调查（2009年、2014年、2017年）。总共纳入了3209名50岁及以上的老年人。PA和SB通过使用全球身体活动问卷（GPAQ）来确定。残疾状况使用世界卫生组织残疾评估量表（WHODAS 2.0）进行测量，生活质量使用世界卫生组织生活质量量表（WHOQOL）进行评估，全因死亡率通过死因推断进行统计。我们使用生长混合模型（GMM）来研究PA和SB的纵向轨迹。采用三级线性混合效应模型来评估PA和SB与生活质量及残疾之间的关联，并使用Cox模型评估与全因死亡率之间的关联。
发现了PA和SB的三种纵向轨迹：PA方面为低身体活动量递减者、中等身体活动量递减者和高身体活动量递减者；SB方面为低维持者、急剧递减者和急剧递增者。生活质量下降、残疾增加和全因死亡率均与较差的PA和SB轨迹始终相关。
我们的研究结果凸显了制定促进中年成年人身体活动并限制久坐行为的卫生政策和预防策略的必要性。进一步的研究应将这些活动/行为视为在整个生命过程中有所变化的暴露因素，并努力确定身体活动干预措施和计划对其最具影响力的老年弱势群体。
