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体力活动变化与高龄人群全因死亡率:来自中国长寿纵向研究(CLHLS)的发现。

Changes in physical activity and all-cause mortality in the oldest old population: Findings from the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

机构信息

Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu, China; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu, China.

出版信息

Prev Med. 2023 Oct;175:107721. doi: 10.1016/j.ypmed.2023.107721. Epub 2023 Oct 4.

Abstract

BACKGROUND

Insufficient or decreasing physical activity is common in older adults. Most studies on physical activity changes and mortality were conducted in adults younger than 80 years old in developed countries. We aimed to investigate the relationship between changes in physical activity and longevity in the oldest old (80 years or older) population using the Chinese Longitudinal Healthy Longevity Survey.

METHODS

Participants aged 80 or older at baseline were categorized into four groups: 1) remaining physically inactive (n = 14,287), 2) remaining physically active (n = 5411), 3) shifting from being inactive to active (n = 1364), and 4) shifting from being active to inactive (n = 1401). We fitted accelerated failure time Weibull survival regression models, adjusting for baseline sociodemographics, lifestyle factors and disease status. We further examined whether the associations differed by subgroups.

RESULTS

A total of 15,707 participants died during follow-up (median duration of follow-up = 3.0 years). Compared with participants who remained physically inactive, those who remained active (fully adjusted event time ratio (ETR): 1.14, 95%CI: 1.11-1.17) or shifted from being inactive to active (fully adjusted ETR: 1.14, 95%CI: 1.08-1.20) had statistically significant longer survival time. No significant association was observed between remaining physically inactive and shifting from being active to inactive. Subgroup analyses showed consistent associations in nearly all strata.

CONCLUSION

Maintaining frequent physical activity or shifting from being physically inactive to active was consistently associated with longer survival time in the oldest old population. Our findings provide evidence for encouraging older adults to regularly engage in physical activity to gain longevity benefits.

摘要

背景

老年人普遍存在体力活动不足或减少的情况。大多数关于体力活动变化与死亡率的研究都是在发达国家年龄小于 80 岁的成年人中进行的。我们旨在使用中国长寿纵向研究调查,研究身体活动变化与最年长老年人(80 岁及以上)寿命之间的关系。

方法

在基线时年龄为 80 岁或以上的参与者被分为四组:1)仍然不活跃(n=14287),2)仍然活跃(n=5411),3)从不活跃变为活跃(n=1364),4)从不活跃变为活跃(n=1401)。我们拟合了加速失效时间 Weibull 生存回归模型,调整了基线社会人口统计学、生活方式因素和疾病状况。我们进一步研究了这些关联是否因亚组而异。

结果

在随访期间共有 15707 名参与者死亡(中位随访时间为 3.0 年)。与仍然不活跃的参与者相比,那些仍然活跃(完全调整后的事件时间比(ETR):1.14,95%CI:1.11-1.17)或从不活跃变为活跃(完全调整后的 ETR:1.14,95%CI:1.08-1.20)的参与者具有更长的生存时间,具有统计学意义。没有发现与仍然不活跃和从不活跃变为活跃之间存在显著关联。亚组分析表明,在几乎所有亚组中都存在一致的关联。

结论

在最年长的老年人中,保持频繁的体力活动或从不活跃变为活跃与更长的生存时间始终相关。我们的研究结果为鼓励老年人定期进行体力活动以获得长寿益处提供了证据。

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