加速度计测量的久坐行为与老年日本成年人功能障碍风险的 9 年前瞻性队列研究。
Accelerometer-measured sedentary behavior and risk of functional disability in older Japanese adults: a 9-year prospective cohort study.
机构信息
Sports and Health Research Center, Department of Physical Education, Tongji University, 1239 Siping Road, Shanghai, 200-092, China.
Global Health Nursing, Department of Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima, 734-8553, Japan.
出版信息
Int J Behav Nutr Phys Act. 2023 Jul 26;20(1):91. doi: 10.1186/s12966-023-01490-6.
BACKGROUND
The associations of sedentary time and patterns with functional disability among older adults remain unclear, and few studies have accounted for the co-dependency of sedentary behavior and physical activities when modeling sedentary behavior with risk of functional disability. We aimed to examine the associations between sedentary time and patterns and risk of incident functional disability, and assess whether replacing sedentary time with light physical activity (LPA) or moderate-to-vigorous intensity physical activity (MVPA) is associated with reduced risk of functional disability in community-dwelling older adults.
METHODS
A total of 1,687 Japanese adults aged ≥ 65 years without functional disability at baseline were prospectively followed-up for 9 years (2011-2020). Functional disability was ascertained using the national database of Japan's Long-term Care Insurance System. Sedentary time and patterns, LPA, and MVPA were measured using a tri-axial accelerometer secured to participants' waists.
RESULTS
During follow-up, 466 participants developed functional disability. Compared with the lowest quartile of total sedentary time, the multivariable-adjusted hazard ratios (95% confidence intervals) of functional disability for the second, third, and top quartiles were 1.21 (0.91‒1.62), 1.45 (1.10‒1.92), and 1.40 (1.05‒1.88) (p for trend = 0.01). After further adjusting for MVPA, total sedentary time was no longer significantly associated with the risk of functional disability (p for trend = 0.41). Replacing 10 min/day of sedentary time with the same amount of MVPA (but not LPA) was significantly associated with a 12% reduced risk of functional disability (hazard ratio [95% confidence interval]: 0.88 [0.84‒0.92]). No significant association was observed between sedentary bout length and functional disability.
CONCLUSION
Higher levels of total sedentary time were associated with an increased risk of incident functional disability. However, this association was not independent of MVPA. Replacing sedentary time with MVPA, but not LPA, was associated with reduced risk of functional disability in older adults.
背景
久坐时间和模式与老年人功能障碍之间的关联尚不清楚，并且很少有研究在使用久坐行为建模功能障碍风险时考虑到久坐行为和身体活动的相互依存性。我们旨在研究久坐时间和模式与新发功能障碍风险之间的关系，并评估用低强度身体活动（LPA）或中等到剧烈强度身体活动（MVPA）代替久坐时间是否与减少社区居住的老年人的功能障碍风险相关。
方法
共有 1687 名年龄≥65 岁且基线时无功能障碍的日本成年人前瞻性随访 9 年（2011-2020 年）。使用日本长期护理保险系统的国家数据库确定功能障碍。使用固定在参与者腰部的三轴加速度计测量久坐时间和模式、LPA 和 MVPA。
结果
在随访期间，有 466 名参与者出现功能障碍。与总久坐时间最低四分位数相比，功能障碍的多变量调整后的危险比（95%置信区间）为第二、第三和最高四分位数分别为 1.21（0.91-1.62）、1.45（1.10-1.92）和 1.40（1.05-1.88）（趋势 P 值=0.01）。进一步调整 MVPA 后，总久坐时间与功能障碍风险不再显著相关（趋势 P 值=0.41）。用相同量的 MVPA（而不是 LPA）代替 10 分钟/天的久坐时间，与功能障碍风险降低 12%显著相关（危险比[95%置信区间]：0.88[0.84-0.92]）。久坐时间长度与功能障碍之间没有观察到显著关联。
结论
较高水平的总久坐时间与新发功能障碍风险增加相关。然而，这种关联与 MVPA 无关。用 MVPA 代替久坐时间而不是 LPA，与老年人功能障碍风险降低相关。
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