School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.
School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom.
Front Public Health. 2024 May 9;12:1371453. doi: 10.3389/fpubh.2024.1371453. eCollection 2024.
Physical inactivity and sedentary behaviour are linked to increased risk of cardiovascular disease, infections and dementia, as well as placing a significant economic burden on healthcare systems. The implementation of COVID-19 pandemic lockdown measures aimed at reducing virus transmission posed challenges to the opportunity to be physically active. This study investigates how the first UK COVID-19 lockdown affected objectively measured physical activity in older adults at higher risk of cardiovascular disease.
We studied 48 individuals aged 55-74 years (81.3% female) with self-reported PA levels < 90 min/week and a QRISK2 score ≥ 10 (indicative of a ≥ 10% risk of a major cardiovascular event in the next 10 years) without mild cognitive impairment or dementia. Physical activity data was collected using objective wrist-based activity monitors and analysed across three time periods, usual activity (pre-pandemic), the precautionary phase when the UK began advising on limiting social contact and finally during the first UK lockdown period was collected (27 January 2020 and 07 June 2020). Data was analysed using linear mixed effects model was used to investigate PA levels over the measured 12-week period. Effects of BMI, age, deprivation score and baseline PA levels on PA across the three measurement periods were also examined. Focus-group and individual interviews were conducted, and data were thematically analysed.
Average daily step count (-34% lower, < 0.001) and active energy expenditure (-26% lower, < 0.001) were significantly lower during the precautionary period compared with the usual activity period. Physical activity remained low during the UK lockdown period. Participants with a lower BMI engaged in significantly more (+45% higher daily steps < 0.001) physical activity and those over 70 years old were more physically active than those under 70 years across the 12-week period (+23% higher daily steps < 0.007). The risk of COVID-19 infection and restrictions because of lockdown measures meant some individuals had to find alternative methods to staying physical active. Participants described a lack of access to facilities and concerns over health related to COVID-19 as barriers to engaging in physical activity during lockdown. For some, this resulted in a shift towards less structured activities such as gardening or going for a walk.
The data presented shows that lockdown measures during the COVID-19 pandemic significantly reduced physical activity among older individuals at risk of cardiovascular disease, particularly those with a higher body mass index. To support this population group in staying active during future lockdowns, a multifaceted strategy is needed, emphasizing psychosocial benefits and home-based physical activity. The MedEx-UK study was pre-registered with ClinicalTrials.gov (NCT03673722).
身体活动不足和久坐行为与心血管疾病、感染和痴呆风险增加有关，同时也给医疗系统带来了巨大的经济负担。为了降低病毒传播而实施的 COVID-19 大流行封锁措施，给人们进行身体活动的机会带来了挑战。本研究旨在调查英国首次 COVID-19 封锁如何影响心血管疾病风险较高的老年人的身体活动。
我们研究了 48 名年龄在 55-74 岁之间（81.3%为女性）、自我报告的身体活动水平<90 分钟/周且 QRISK2 评分≥10（表示在未来 10 年内发生重大心血管事件的风险≥10%）、无轻度认知障碍或痴呆的个体。使用客观的腕部活动监测器收集身体活动数据，并在三个时间段进行分析：通常的活动（大流行前）、英国开始建议限制社会接触的预防阶段以及第一次英国封锁期间（2020 年 1 月 27 日至 2020 年 6 月 7 日）。使用线性混合效应模型分析了 12 周内的身体活动水平。还检查了 BMI、年龄、贫困评分和基线身体活动水平对三个测量期间身体活动的影响。进行了焦点小组和个人访谈，并对数据进行了主题分析。
与通常的活动期相比，预防期的平均每日步数（低 34%，<0.001）和活跃能量消耗（低 26%，<0.001）显著降低。在英国封锁期间，身体活动仍然很低。BMI 较低的参与者的身体活动量明显增加（每日多走 45%，<0.001），70 岁以上的参与者在 12 周内比 70 岁以下的参与者更活跃（每日多走 23%，<0.007）。COVID-19 感染的风险和封锁措施的限制意味着一些人不得不寻找替代方法来保持身体活跃。参与者描述说，由于缺乏设施和对 COVID-19 相关健康的担忧，这成为了在封锁期间进行身体活动的障碍。对一些人来说，这导致他们转向不太结构化的活动，例如园艺或散步。
所呈现的数据表明，COVID-19 大流行期间的封锁措施显著降低了心血管疾病风险较高的老年人的身体活动水平，尤其是那些体重指数较高的老年人。为了在未来的封锁期间支持这一人群保持活跃，需要采取多方面的策略，强调心理社会益处和家庭身体活动。MedEx-UK 研究已在 ClinicalTrials.gov 上进行了预注册（NCT03673722）。
