Department of Rehabilitation Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.
Department of Rehabilitation Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China; Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China; School of Rehabilitation Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China.
J Am Med Dir Assoc. 2024 Jul;25(7):105010. doi: 10.1016/j.jamda.2024.03.121. Epub 2024 Apr 30.
Although studies have indicated that physical activity (PA) is related to cardiovascular disease, the specific association between PA and incident cerebrovascular disease (CBVD) remains uncertain. The current study aimed to investigate the associations between PA levels and the CBVD incidence or all-cause mortality.
Prospective cohort study.
Older participants (aged >60 years) from the UK Biobank.
The baseline PA was classified as total, light, moderate, and vigorous PA based on the metabolic equivalent-minutes per week (MET-min/wk) and considered as exposures, whereas CBVD incidence and all-cause mortality were considered as the outcomes. Cox proportional hazards were used to calculate the hazard ratios (HRs) and 95% CIs for the influence of the association between PA and CBVD incidence and all-cause mortality.
A total of 146,742 participants aged 60 years and older were included. During a median follow-up period of 13.5 years (interquartile range of 12.8-14.2), 9338 older individuals developed CBVD and 3033 death were recorded (including 767 CBVD-related deaths). High volumes of PA were consistently associated with lower risks of CBVD and all-cause mortality. The lowest risk of CBVD incidence was observed at 2001-2500 MET-min/wk of total PA (HR 0.61, 95% CI 0.53-0.70), and the lowest risk of all-cause mortality was observed at 2501-5000 MET-min/wk (HR 0.52, 95% CI 0.43-0.63) in older adults. Total PA at 2001-2500 MET-min/wk significantly reduced the CBVD incidence in older women (HR 0.57, 95% CI 0.46-0.71), which was more pronounced than that in older men (HR for 2001-2500 MET-min/wk: 0.64, 95% CI 0.50-0.77).
Total PA at 2001-2500 MET-min/wk significantly reduced the risk of incident CBVD and all-cause mortality in adults aged >60 years, although the extents of risk reduction vary in men and women.
尽管已有研究表明，身体活动（PA）与心血管疾病有关，但 PA 与脑血管疾病（CBVD）发病之间的具体关联仍不确定。本研究旨在探讨 PA 水平与 CBVD 发病或全因死亡率之间的关系。
前瞻性队列研究。
来自英国生物库的老年参与者（年龄＞60 岁）。
根据代谢当量分钟/周（MET-min/wk），将基线 PA 分为总 PA、低强度 PA、中强度 PA 和高强度 PA，将其作为暴露因素，而将 CBVD 发病和全因死亡率作为结局。采用 Cox 比例风险模型计算 PA 与 CBVD 发病和全因死亡率之间关联的风险比（HR）和 95%置信区间（CI）。
共纳入 146742 名年龄＞60 岁的参与者。中位随访时间为 13.5 年（四分位间距 12.8-14.2 年），9338 名老年人发生 CBVD，3033 人死亡（包括 767 例与 CBVD 相关的死亡）。高 PA 量与较低的 CBVD 和全因死亡率风险相关。总 PA 为 2001-2500 MET-min/wk 时，CBVD 发病风险最低（HR 0.61，95%CI 0.53-0.70），总 PA 为 2501-5000 MET-min/wk 时，全因死亡率风险最低（HR 0.52，95%CI 0.43-0.63）。总 PA 为 2001-2500 MET-min/wk 时，老年女性的 CBVD 发病风险显著降低（HR 0.57，95%CI 0.46-0.71），这一效果在老年男性中更为显著（HR 为 2001-2500 MET-min/wk：0.64，95%CI 0.50-0.77）。
总 PA 为 2001-2500 MET-min/wk 时，可显著降低＞60 岁成年人的 CBVD 发病风险和全因死亡率风险，尽管男性和女性的风险降低程度不同。
