与加速度计测量的身体活动和久坐时间相关的心血管疾病风险和全因死亡率——一项针对老年人的前瞻性基于人群的研究。
Cardiovascular disease risk and all-cause mortality associated with accelerometer-measured physical activity and sedentary time ‒ a prospective population-based study in older adults.
机构信息
Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Albertinkatu 18 A, 90100, Oulu, Finland.
Research Unit of Population Health, University of Oulu, Oulu, Finland.
出版信息
BMC Geriatr. 2022 Sep 5;22(1):729. doi: 10.1186/s12877-022-03414-8.
BACKGROUND
Low levels of physical activity (PA) and high sedentary time (ST) are common in older adults and lack of PA is a risk factor for cardiovascular disease (CVD). Knowledge about associations with accelerometer-measured PA, ST and CVD risk in older adults is insufficient. This study examines the associations of accelerometer-measured PA and ST with cardiovascular risk measured using the Framingham risk score (FRS) and all-cause mortality in older adults.
METHODS
A population-based sample of 660 (277 men, 383 women) older people (mean age 68.9) participated in the Oulu45 cohort study from 2013‒2015. PA and ST were measured with wrist-worn accelerometers at baseline for two weeks. Ten-year CVD risk (%) was estimated with FRS. The data for all-cause mortality were identified from the Digital and Population Data Services Agency, Finland after an average of 6.2 years follow-up. The associations between moderate to vigorous physical activity (MVPA), light physical activity (LPA), ST and FRS were analyzed using the multivariable linear regression analysis. Associations between LPA, ST and mortality were analyzed using the Cox proportional-hazard regression models.
RESULTS
Each 10 min increase in MVPA (β = -0.779, 95% CI -1.186 to -0.371, p < 0.001) and LPA (β = -0.293, 95% CI -0.448 to -0.138, p < 0.001) was negatively associated with FRS while a 10 min increase in ST (β = 0.290, 95% CI 0.158 to 0.421, p < 0.001) was positively associated with FRS. After adjustment for waist circumference, only ST was significantly associated with FRS. Each 10 min increase in LPA was associated with 6.5% lower all-cause mortality risk (HR = 0.935, 95% CI 0.884 to 0.990, p = 0.020) and each 10 min increase in ST with 5.6% increased mortality risk (HR = 1.056, 95% CI 1.007 to 1.108, p = 0.025).
CONCLUSION
A higher amount of daily physical activity, at any intensity level, and avoidance of sedentary time are associated with reduced cardiovascular disease risk in older people. Higher time spent in light physical activity and lower sedentary time are associated with lower all-cause mortality.
背景
体力活动（PA）水平低和久坐时间（ST）长在老年人中很常见，而缺乏 PA 是心血管疾病（CVD）的一个风险因素。关于加速度计测量的 PA、ST 与老年人 CVD 风险之间的关联的知识还不够充分。本研究旨在探讨加速度计测量的 PA 和 ST 与Framingham 风险评分（FRS）测量的心血管风险以及老年人全因死亡率之间的关系。
方法
2013 年至 2015 年，一项基于人群的 660 名（277 名男性，383 名女性）老年人（平均年龄 68.9 岁）参与了奥卢 45 队列研究。在基线时，使用佩戴在手腕上的加速度计对 PA 和 ST 进行了两周的测量。使用 Framingham 风险评分（FRS）估计 10 年 CVD 风险（%）。在平均 6.2 年的随访后，通过芬兰的数字和人口数据服务机构（Digital and Population Data Services Agency）获取全因死亡率数据。使用多变量线性回归分析评估 MVPA、LPA、ST 与 FRS 之间的关系。使用 Cox 比例风险回归模型分析 LPA、ST 与死亡率之间的关系。
结果
MVPA（β=-0.779，95%CI -1.186 至 -0.371，p<0.001）和 LPA（β=-0.293，95%CI -0.448 至 -0.138，p<0.001）每增加 10 分钟，与 FRS 呈负相关，而 ST（β=0.290，95%CI 0.158 至 0.421，p<0.001）每增加 10 分钟，与 FRS 呈正相关。在校正腰围后，只有 ST 与 FRS 呈显著相关。LPA 每增加 10 分钟，全因死亡率风险降低 6.5%（HR=0.935，95%CI 0.884 至 0.990，p=0.020），ST 每增加 10 分钟，死亡率风险增加 5.6%（HR=1.056，95%CI 1.007 至 1.108，p=0.025）。
结论
在老年人中，每天进行更多的体力活动（无论强度如何）和避免久坐时间，与降低心血管疾病风险有关。花更多的时间进行低强度体力活动和减少久坐时间，与降低全因死亡率有关。
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