Yerramalla Manasa Shanta, Chen Mathilde, Dugravot Aline, van Hees Vincent T, Sabia Severine
Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France.
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden.
BMJ Open Sport Exerc Med. 2024 Jun 27;10(2):e001873. doi: 10.1136/bmjsem-2023-001873. eCollection 2024.
We identified profiles of wake-time movement behaviours (sedentary behaviours, light intensity physical activity and moderate-to-vigorous physical activity) based on accelerometer-derived features among older adults and then examined their association with all-cause mortality.
Data were drawn from a prospective cohort of 3991 Whitehall II accelerometer substudy participants aged 60-83 years in 2012-2013. Daily movement behaviour profiles were identified using k-means cluster analysis based on 13 accelerometer-assessed features characterising total duration, frequency, bout duration, timing and activity intensity distribution of movement behaviour. Cox regression models were used to assess the association between derived profiles and mortality risk.
Over a mean follow-up of 8.1 (SD 1.3) years, a total of 410 deaths were recorded. Five distinct profiles were identified and labelled as 'active' (healthiest), 'active sitters', 'light movers', 'prolonged sitters', and 'most sedentary' (most deleterious). In model adjusted for sociodemographic, lifestyle, and health-related factors, compared with the 'active' profile, 'active sitters' (HR 1.57, 95% CI 1.01 to 2.44), 'light movers' (HR 1.75, 95% CI 1.17 to 2.63), 'prolonged sitters' (HR 1.67, 95% CI 1.11 to 2.51), 'most sedentary' (HR 3.25, 95% CI 2.10 to 5.02) profiles were all associated with a higher risk of mortality.
Given the threefold higher mortality risk among those with a 'most sedentary' profile, public health interventions may target this group wherein any improvement in physical activity and sedentary behaviour might be beneficial.
我们基于加速度计得出的特征,确定了老年人清醒时间的运动行为模式(久坐行为、轻度体力活动和中度至剧烈体力活动),并研究了这些模式与全因死亡率之间的关联。
数据来自2012 - 2013年怀特霍尔二世加速度计子研究中3991名年龄在60 - 83岁的参与者组成的前瞻性队列。基于13个加速度计评估特征(表征运动行为的总时长、频率、单次持续时间、时间安排和活动强度分布),使用k均值聚类分析确定每日运动行为模式。采用Cox回归模型评估得出的模式与死亡风险之间的关联。
在平均8.1(标准差1.3)年的随访期内,共记录到410例死亡。确定了五种不同的模式,并分别标记为“活跃型”(最健康)、“活跃久坐型”、“轻度运动型”、“久坐延长型”和“最久坐型”(最有害)。在对社会人口统计学、生活方式和健康相关因素进行调整的模型中,与“活跃型”模式相比,“活跃久坐型”(风险比1.57,95%置信区间1.01至2.44)、“轻度运动型”(风险比1.75,95%置信区间1.17至2.63)、“久坐延长型”(风险比1.67,95%置信区间1.11至2.51)、“最久坐型”(风险比3.25,95%置信区间2.10至5.02)模式均与更高的死亡风险相关。
鉴于“最久坐型”模式人群的死亡风险高出三倍,公共卫生干预措施可能应以该群体为目标,其中体力活动和久坐行为的任何改善都可能有益。