Graduate Institute of Sports and Health Management, National Chung Hsing University, 402 Taichung, Taiwan; Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; Department of Kinesiology, National Tsing Hua University, Hsinchu City 402, Taiwan.
Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK.
Exp Gerontol. 2023 May;175:112148. doi: 10.1016/j.exger.2023.112148. Epub 2023 Mar 23.
BACKGROUND AND PURPOSE: Although leisure-time physical activity (PA) has established health benefits in older adults, it is equivocal if exercising in environments with high levels of PM concentrations is equally beneficial for them. To explore the independent and joint associations of ambient PM and PA with all-cause mortality among adults aged 60 or older and to assess the modifying effect of age (60-74 years vs. 75+ years) on the joint associations. METHODS: A prospective cohort study based on the MJ Cohort repeat examinations (2005-2016) and the Taiwan Air Quality Monitoring Network and death registry linkages (2005-2022). We included MJ Cohort participants aged 60 or more at baseline who attended the health check-ups at least twice (n = 21,760). Metabolic equivalent hours per week (MET-h/week) of leisure-time PA were computed. Multivariable adjusted associations were examined using time-varying Cox proportional hazard models. RESULTS: There were 3539 all-cause deaths over a mean follow-up of 12.81 (SD = 3.67) years. Ambient PM and physical inactivity are both independently associated with all-cause mortality. The joint associations of PA and PM concentrations with all-cause mortality differed in the young-old (60-74 years) and the older-old (75+ years) (P for interaction = 0.01); Higher levels of long-term PM exposures (≥25 μg/m) had little influence on the associations between PA and mortality in the young-old (HR = 0.68 (0.56-0.83) and HR = 0.72 (0.59-0.88) for participants with 7.5-<15 and 15+ MET-h/week respectively) but eliminated associations between exposure and outcome in the older-old (HR = 0.91 (0.69-01.21) and HR = 1.02 (0.76-1.38) for participants with 7.5-<15 and 15+ MET-h/week). CONCLUSION: Long-term exposures to higher PM concentrations may eliminate the beneficial associations of PA with all-cause mortality among adults aged 75 and over.
背景与目的：尽管休闲时间体力活动（PA）对老年人有明确的健康益处，但在 PM 浓度较高的环境中进行锻炼是否对他们同样有益仍存在争议。本研究旨在探索环境 PM 和 PA 与 60 岁及以上成年人全因死亡率的独立和联合关联，并评估年龄（60-74 岁与 75 岁及以上）对联合关联的修饰作用。
方法：本研究基于 MJ 队列重复检查（2005-2016 年）和台湾空气质量监测网络与死亡登记链接（2005-2022 年）进行了一项前瞻性队列研究。我们纳入了基线时年龄在 60 岁及以上且至少参加过两次健康检查（n=21760）的 MJ 队列参与者。计算每周代谢当量小时（MET-h/周）的休闲时间 PA。使用时变 Cox 比例风险模型来检验多变量调整后的关联。
结果：在平均 12.81（SD=3.67）年的随访期间，共有 3539 例全因死亡。环境 PM 和体力活动不足均与全因死亡率独立相关。PA 和 PM 浓度的联合关联在年轻老年人（60-74 岁）和老年老年人（75 岁及以上）之间存在差异（交互作用 P 值=0.01）；长期 PM 暴露水平较高（≥25μg/m）对年轻老年人中 PA 与死亡率之间的关联影响较小（对于每周 7.5-<15 和 15+MET-h 的参与者，HR 值分别为 0.68（0.56-0.83）和 0.72（0.59-0.88）），但消除了老年老年人中暴露与结局之间的关联（对于每周 7.5-<15 和 15+MET-h 的参与者，HR 值分别为 0.91（0.69-01.21）和 1.02（0.76-1.38））。
结论：长期暴露于较高 PM 浓度可能会消除 75 岁及以上成年人中 PA 与全因死亡率之间的有益关联。
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