Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK.
MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, UK.
Health Qual Life Outcomes. 2023 Jun 22;21(1):60. doi: 10.1186/s12955-023-02137-7.
No previous studies have examined the associations between changes in objectively-measured physical behaviours with follow-up QoL in older adults. Based on cross-sectional evidence, it is biologically plausible that such associations exist. If so, this bolsters the case for the commissioning of activity interventions and for including QoL as an outcome in trials of such interventions.
We assessed physical behaviours (total physical activity, moderate-to-vigorous physical activity (MVPA), light physical activity, total sedentary time and prolonged sedentary bout time) for 7 days using hip-worn accelerometers at baseline (2006-2011) and follow-up (2012-2016) and health-related quality-of-life (QoL) using EQ-5D questionnaires at follow-up in 1433 participants (≥ 60 years) of the EPIC (European Prospective Investigation into Cancer)-Norfolk study. The EQ-5D summary score was used, with 0 as the worst to 1 as best perceived quality-of-life. We evaluated the prospective associations of baseline physical behaviours with follow-up QoL, and of changes in behaviours with follow-up QoL using multi-level regression.
On average, MVPA decreased by 4.0 min/day/year (SD 8.3) for men and 4.0 min/day/year for women (SD 12.0) between baseline and follow-up. Total sedentary time increased by an average 5.5 min/day/yr (SD 16.0) for men and 6.4 min/day/yr (SD 15.0) for women between baseline and follow-up. Mean (SD) follow-up time was 5.8 (1.8) years. We found that higher baseline MVPA and lower sedentary time was associated with higher subsequent QoL (e.g. 1 h/day greater baseline MVPA was associated with 0.02 higher EQ-5D score, 95% CI 0.06, 0.36). More pronounced declines in activity were associated with worse Hr-QoL (0.005 (95% CI 0.003, 0.008) lower EQ-5D per min/day/yr decrease in MVPA). Increases in sedentary behaviours were also associated with poorer QoL (0.002 lower EQ-5D, 95% CI -0.003, -0.0007 per hour/day/yr increase in total sedentary time).
Promotion of physical activity and limiting sedentary time among older adults may improve quality-of-life, and therefore this relationship ought to be included in future cost effectiveness analyses so that greater commissioning of activity interventions can be considered.
之前的研究没有考察老年人中通过客观测量的身体行为变化与随访生活质量之间的关系。基于横断面证据，这种关联在生物学上是合理的。如果是这样，这就支持了为活动干预制定计划，并将生活质量作为此类干预试验的结果纳入其中。
我们使用佩戴在臀部的加速度计在基线（2006-2011 年）和随访（2012-2016 年）期间评估了 7 天的身体行为（总体力活动、中高强度体力活动（MVPA）、低强度体力活动、总久坐时间和长时间久坐时间），并在 1433 名（≥60 岁）欧洲癌症前瞻性调查（EPIC）-诺福克研究参与者的随访中使用 EQ-5D 问卷评估了健康相关生活质量（QoL）。使用 EQ-5D 综合评分，0 为最差，1 为最佳感知生活质量。我们使用多层次回归评估了基线身体行为与随访 QoL 的前瞻性关联，以及行为变化与随访 QoL 的关联。
平均而言，男性 MVPA 每天减少 4.0 分钟/年（SD 8.3），女性每天减少 4.0 分钟/年（SD 12.0）。男性总久坐时间每天增加 5.5 分钟/年（SD 16.0），女性每天增加 6.4 分钟/年（SD 15.0）。平均（SD）随访时间为 5.8（1.8）年。我们发现，较高的基线 MVPA 和较低的久坐时间与较高的后续 QoL 相关（例如，每天增加 1 小时的基线 MVPA 与 EQ-5D 评分增加 0.02 相关，95%CI 0.06，0.36）。活动量明显下降与较差的健康相关生活质量相关（MVPA 每天减少 0.005 分钟/年，95%CI 0.003，0.008）。久坐行为的增加也与较差的 QoL 相关（总久坐时间每天增加 0.002 分钟/年，95%CI -0.003，-0.0007）。
在老年人中促进身体活动和限制久坐时间可能会提高生活质量，因此，未来的成本效益分析应将这种关系纳入其中，以便更多地考虑开展活动干预。
