Kanamori Satoru, Kai Yuko, Yamaguchi Daisuke, Tsuji Taishi, Watanabe Ryota, Kondo Katsunori
Teikyo University Graduate School of Public Health.
Department of Preventive Medicine and Public Health, Tokyo Medical University.
Nihon Koshu Eisei Zasshi. 2022 Dec 17;69(11):861-873. doi: 10.11236/jph.21-141. Epub 2022 Jun 30.
Objectives Some older adults less interested in exercise may still meet the walking time of 30 minutes or more per day that is required to maintain and improve their health. This study aimed to clarify the characteristics of those who walk for 30 minutes or more per day stratified by the exercise stage of change.Methods This cross-sectional study used a self-administered mail survey conducted by the Japan Gerontological Evaluation Study (JAGES) in 2019. There were 45,939 participants, aged 65 years or above, who were not certified as requiring long-term care and who resided in 62 municipalities in 24 prefectures. The measures included daily walking time, stage of change for exercise (20 minutes or more once a week), and factors related to physical activities (eight demographic and biological; three psychological, cognitive, and emotional; eight behavioral; 40 social and cultural; and three environmental factors). The analysis was stratified into three groups according to the transformation stages: 1) pre-contemplation, 2) contemplation/preparation, and 3) action/maintenance. Poisson regression analysis was conducted with the dependent variable as walking time, the independent variables as physical activity factors, and the covariates as all eight demographic and biological factors.Results Of the 24,146 survey respondents (52.6% response rate), 18,464 were included in the analysis. Surveys with missing items that were important for the analysis and patients who needed care and assistance were excluded. The factors that were significantly associated with walking 30 minutes or more per day only in the pre-contemplation stage, or only in the precontemplation and the contemplation/preparation stages, were three demographic and biological (married; age 80 years or above and non-independence of instrumental activities of daily living were negatively associated), two behavioral (going out at least once a week and watching sports on TV or the Internet), and six social and cultural factors (provision of instrumental support, frequency of meeting with friends more than once a week, participation in the neighborhood association, high reciprocity, reading habits; playing Go was negatively associated).Conclusions Among the demographic and biological factors, and the behavioral, social, and cultural factors, 11 items were found to be associated with walking 30 minutes or more per day only in the pre-contemplation stage, or only in the precontemplation and contemplation/preparation stages. To promote walking even in the lower stages of change, it may be useful to promote exchanges with others, rather than focusing predominantly on physical activities.
目的 一些对运动兴趣较低的老年人可能仍能达到每天步行30分钟或更长时间的要求，这对于维持和改善他们的健康是必要的。本研究旨在阐明按运动改变阶段分层的每天步行30分钟或更长时间的人群的特征。
方法 本横断面研究采用了日本老年学评估研究（JAGES）于2019年进行的自填式邮件调查。共有45939名年龄在65岁及以上、未被认证为需要长期护理且居住在24个县的62个市的参与者。测量指标包括每日步行时间、运动改变阶段（每周一次20分钟或更长时间）以及与身体活动相关的因素（八个人口统计学和生物学因素；三个心理、认知和情感因素；八个行为因素；40个社会和文化因素；以及三个环境因素）。根据转变阶段将分析分为三组：1）未考虑阶段，2）考虑/准备阶段，3）行动/维持阶段。以步行时间为因变量，身体活动因素为自变量，所有八个人口统计学和生物学因素为协变量进行泊松回归分析。
结果 在24146名调查受访者（回复率52.6%）中，18464人被纳入分析。排除了对分析重要的项目缺失的调查以及需要护理和协助的患者。仅在未考虑阶段或仅在未考虑阶段和考虑/准备阶段与每天步行30分钟或更长时间显著相关的因素包括三个人口统计学和生物学因素（已婚；80岁及以上且工具性日常生活活动不独立呈负相关），两个行为因素（每周至少外出一次以及在电视或互联网上观看体育节目），以及六个社会和文化因素（提供工具性支持、每周与朋友见面不止一次的频率、参与邻里协会、高互惠性、阅读习惯；下围棋呈负相关）。
结论 在人口统计学和生物学因素以及行为、社会和文化因素中，发现有11项因素仅在未考虑阶段或仅在未考虑阶段和考虑/准备阶段与每天步行30分钟或更长时间相关。为了在较低的改变阶段促进步行，促进与他人的交流可能比主要关注身体活动更有用。
