School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
BMC Geriatr. 2024 Oct 26;24(1):886. doi: 10.1186/s12877-024-05493-1.
This study aims to assess the joint and independent effects of self-reported physical activity and sedentary behavior on mortality in older persons.
A prospective community-based cohort study was conducted to examine physical activity (PA) level and sitting time (ST) in relation to mortality among 1,786 older persons aged 65 years and above. PA was assessed by a checklist of 26 self-reported items about PA and hours per week, and the metabolic equivalent hours/week was derived, and ST was measured by a self-reported item asking the average number of hours spent sitting per day. The participants were divided into four combination groups of PA and ST based on WHO guideline and values found in literature: high PA/short ST group, high PA/long ST group, low PA/long ST group, and low PA/short ST group. Data on death ascertainment were obtained through linkage with the national death datasets and expanded cardiovascular disease (CVD) included cardiovascular disease, diabetes, and chronic kidney disease.
After follow-up for a median 11.1 years, 599 mortality cases were recorded, giving a crude all-cause mortality of 32.5/1,000 person-years, CVD mortality of 8.6/1,000 person-years, expanded CVD mortality of 11.9/1,000 person-years, and nonexpanded CVD mortality of 20.8/1,000 person-years. For all-cause, and expanded CVD, the hazards ratios (HRs) for the low PA/long ST group remained significant compared with that for the high PA/short ST group after all covariates were considered [HRs for all-cause mortality: 1.4 [95% confidence interval (CI) 1.1, 1.8]; and expanded CVD mortality: 1.7 (95% CI 1.1, 2.4).
The independent effect of PA and the joint effects of PA and ST are associated with all-cause and expanded CVD death risks. Expanded CVD mortality may be minimized by engaging in PA and reducing sedentary behaviors.
本研究旨在评估自我报告的体力活动和久坐行为对老年人死亡率的联合和独立影响。
进行了一项前瞻性社区为基础的队列研究，以检查体力活动（PA）水平和坐姿时间（ST）与 1786 名 65 岁及以上老年人死亡率之间的关系。PA 通过 26 项自我报告的 PA 项目和每周小时数检查表进行评估，代谢当量小时/周得出，ST 通过自我报告的每天平均坐立时间的项目进行测量。参与者根据世卫组织指南和文献中的数值被分为 PA 和 ST 的四个组合组：高 PA/短 ST 组、高 PA/长 ST 组、低 PA/长 ST 组和低 PA/短 ST 组。通过与国家死亡数据集的链接获得死亡确定数据，并扩展了心血管疾病（CVD）包括心血管疾病、糖尿病和慢性肾病。
中位随访 11.1 年后，记录了 599 例死亡病例，粗全因死亡率为 32.5/1000 人年，CVD 死亡率为 8.6/1000 人年，扩展 CVD 死亡率为 11.9/1000 人年，非扩展 CVD 死亡率为 20.8/1000 人年。对于全因和扩展 CVD，在考虑所有协变量后，低 PA/长 ST 组与高 PA/短 ST 组相比，风险比（HRs）仍然显著[全因死亡率的 HRs：1.4（95%置信区间 1.1，1.8）；和扩展 CVD 死亡率：1.7（95%置信区间 1.1，2.4）]。
PA 的独立影响以及 PA 和 ST 的联合作用与全因和扩展 CVD 死亡风险相关。通过参与 PA 和减少久坐行为，可能会将扩展 CVD 死亡率降至最低。
