Kamimura Shoto, Iida Takashi, Watanabe Yumi, Kitamura Kaori, Kabasawa Keiko, Takahashi Akemi, Saito Toshiko, Kobayashi Ryosaku, Oshiki Rieko, Takachi Ribeka, Tsugane Shoichiro, Iki Masayuki, Sasaki Ayako, Yamazaki Osamu, Watanabe Kei, Nakamura Kazutoshi
Niigata University School of Medicine, Niigata, Japan.
Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Eur Rev Aging Phys Act. 2022 Sep 2;19(1):20. doi: 10.1186/s11556-022-00300-5.
Falls are important causes of injury and mortality in older people, and associated medical costs can be enormous. Physical activity (PA) is a potential preventive factor for falls. However, few studies have examined the effect of different types of PA on fall prevention. This study aimed to evaluate the association between PA levels and the incidence of recurrent falls by type of PA in middle-aged and older people.
This cohort study targeted 7,561 community-dwelling individuals aged 40-74 years who did not experience recurrent falls in the year before baseline. Information on PA levels, demographics, body size, lifestyle, and fall/disease history was obtained using a self-administered questionnaire in the baseline survey. Levels of total PA, leisure-time PA, and non-leisure-time PA (occupation, commuting, and housework) were estimated using metabolic equivalent (MET) scores (MET-h/day; hours spent on a given activity per day multiplied by its MET intensity). PA levels were categorized into four groups. Falls were recorded as none, once, or twice or more (recurrent falls). The outcome of the study was the incidence of recurrent falls in the past year before a survey conducted 5 years after the baseline survey. Logistic regression analyses were performed to calculate odds ratios for recurrent falls.
Higher total PA and non-leisure-time PA levels were associated with a higher risk of recurrent falls (P for trend = 0.0002 and 0.0001, respectively), with the highest total PA and non-leisure-time PA groups having a significantly higher adjusted OR (1.96 [95%CI:1.33-2.88] and 2.15 [95%CI:1.48-3.14], respectively) relative to the lowest group (reference). As for leisure-time PA, the medium group had a significantly lower adjusted OR (0.70 [95%CI:0.49-0.99]) relative to the reference group. By sex, the adjusted OR in the medium leisure-time PA group was significantly lower relative to the reference group in women (0.50 [95%CI: 0.29-0.85]) but not in men.
Medium level leisure-time PA reduces the risk of recurrent falls in middle-aged and older people, whereas higher level non-leisure-time PA is associated with a higher risk of recurrent falls.
跌倒是老年人受伤和死亡的重要原因，相关医疗费用可能巨大。身体活动（PA）是跌倒的一个潜在预防因素。然而，很少有研究探讨不同类型的身体活动对预防跌倒的影响。本研究旨在评估中老年人的身体活动水平与按身体活动类型划分的反复跌倒发生率之间的关联。
本队列研究针对7561名年龄在40 - 74岁的社区居民，他们在基线前一年未经历反复跌倒。在基线调查中使用自填问卷获取有关身体活动水平、人口统计学、身体尺寸、生活方式以及跌倒/疾病史的信息。使用代谢当量（MET）评分（MET - h/天；每天在特定活动上花费的小时数乘以其MET强度）来估计总身体活动、休闲时间身体活动和非休闲时间身体活动（职业、通勤和家务）的水平。身体活动水平分为四组。跌倒记录为无、一次或两次及以上（反复跌倒）。研究结果是在基线调查后5年进行的一次调查前一年的反复跌倒发生率。进行逻辑回归分析以计算反复跌倒的比值比。
较高的总身体活动和非休闲时间身体活动水平与反复跌倒风险较高相关（趋势P值分别为0.0002和0.0001），总身体活动和非休闲时间身体活动水平最高的组相对于最低组（参照组）具有显著更高的调整后比值比（分别为1.96 [95%CI：1.33 - 2.88]和2.15 [95%CI：1.48 - 3.14]）。至于休闲时间身体活动，中等水平组相对于参照组具有显著更低的调整后比值比（0.70 [95%CI：0.49 - 0.99]）。按性别划分，中等休闲时间身体活动组的调整后比值比相对于女性参照组显著更低（0.50 [95%CI：0.29 - 0.85]），但在男性中并非如此。
中等水平的休闲时间身体活动可降低中老年人反复跌倒的风险，而较高水平的非休闲时间身体活动与反复跌倒风险较高相关。
