Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.
School of Nursing, Beijing University of Chinese Medicine, No. 11, Beisanhuandonglu, Chaoyang District, Beijing, People's Republic of China.
BMC Geriatr. 2024 Jun 6;24(1):502. doi: 10.1186/s12877-024-05076-0.
Sedentary behavior (SB) is deeply ingrained in the daily lives of community-dwelling older adults with type 2 diabetes mellitus (T2DM). However, the specific underlying mechanisms of the determinants associated with SB remain elusive. We aimed to explore the determinants of SB based on the behavior change wheel framework as well as a literature review.
This cross-sectional study recruited 489 community-dwelling older adults with T2DM in Jinan City, Shandong Province, China. Convenience sampling was used to select participants from relevant communities. This study used the Measure of Older Adults' Sedentary Time-T2DM, the Abbreviated-Neighborhood Environment Walkability Scale, the Social Support Rating Scale, the Lubben Social Network Scale 6, the Subjective Social Norms Questionnaire for Sedentary Behavior, the Functional Activities Questionnaire, the Numerical Rating Scale, the Short Physical Performance Battery, and the Montreal Cognitive Assessment Text to assess the levels of and the determinants of SB. Descriptive statistical analysis and path analysis were conducted to analyze and interpret the data.
Pain, cognitive function, social isolation, and social support had direct and indirect effects on SB in community-dwelling older adults with T2DM (total effects: β = 0.426, β = -0.171, β = -0.209, and β = -0.128, respectively), and physical function, walking environment, and social function had direct effects on patients' SB (total effects: β = -0.180, β = -0.163, and β = 0.127, respectively). All the above pathways were statistically significant (P < 0.05). The path analysis showed that the model had acceptable fit indices: RMSEA = 0.014, χ /df = 1.100, GFI = 0.999, AGFI = 0.980, NFI = 0.997, RFI = 0.954, IFI = 1.000, TLI = 0.996, CFI = 1.000.
Capability (physical function, pain, and cognitive function), opportunity (social isolation, walking environment, and social support), and motivation (social function) were effective predictors of SB in community-dwelling older adults with T2DM. Deeper knowledge regarding these associations may help healthcare providers design targeted intervention strategies to decrease levels of SB in this specific population.
久坐行为（SB）深深植根于社区居住的 2 型糖尿病（T2DM）老年患者的日常生活中。然而，与 SB 相关的决定因素的具体潜在机制仍难以捉摸。我们旨在根据行为改变车轮框架以及文献综述来探讨 SB 的决定因素。
本横断面研究招募了中国山东省济南市的 489 名社区居住的 T2DM 老年患者。便利抽样法从相关社区中选择参与者。本研究使用了《老年人久坐时间-2 型糖尿病量表》、《简化邻里环境步行能力量表》、《社会支持评定量表》、《卢本社会网络量表 6 版》、《久坐行为主观社会规范问卷》、《功能性活动问卷》、《数字评分量表》、《简短体能测试电池》和《蒙特利尔认知评估文本》来评估 SB 水平和决定因素。采用描述性统计分析和路径分析对数据进行分析和解释。
疼痛、认知功能、社会隔离和社会支持对社区居住的 T2DM 老年患者的 SB 有直接和间接影响（总效应：β=0.426、β=-0.171、β=-0.209 和β=-0.128），身体功能、步行环境和社会功能对患者的 SB 有直接影响（总效应：β=-0.180、β=-0.163 和β=0.127）。所有上述途径均具有统计学意义（P<0.05）。路径分析显示，该模型具有可接受的拟合指数：RMSEA=0.014、χ/df=1.100、GFI=0.999、AGFI=0.980、NFI=0.997、RFI=0.954、IFI=1.000、TLI=0.996、CFI=1.000。
能力（身体功能、疼痛和认知功能）、机会（社会隔离、步行环境和社会支持）和动机（社会功能）是社区居住的 T2DM 老年患者 SB 的有效预测因素。更深入地了解这些关联可能有助于医疗保健提供者设计针对特定人群的干预策略，以降低 SB 水平。
