Meister Daniel J, Kehler D Scott, Bouchard Danielle R, Thomson Amy M, Sénéchal Martin
Cardiometabolic Exercise & Lifestyle Laboratory, University of New Brunswick, 90 MacKay Dr Room: 105, Fredericton, NB, E3B 5A3, Canada.
Faculty of Kinesiology, University of New Brunswick, 90 MacKay Dr Room: 105, Fredericton, NB, E3B 5A3, Canada.
J Act Sedentary Sleep Behav. 2024 Jul 5;3(1):17. doi: 10.1186/s44167-024-00056-6.
Adherence to the Canadian 24-Hour Movement Guidelines (24 H-MG) has been associated with a reduced risk of developing various chronic conditions. However, its association with frailty and all-cause mortality has not been investigated. Therefore, our primary and secondary objective was to investigate the association between adherence to the 24 H-MG and frailty and mortality, respectively.
This study included 2739 individuals (age = 50.6 ± 18.1 years; male = 1370 (50.0%)) from the 2005-2006 cycle of the National Health and Nutrition Examination Survey (NHANES). Frailty was quantified with a 46-item frailty index and analyzed cross-sectionally using linear regression. All-cause mortality data were obtained from the National Death Index and was analyzed prospectively over 10 years using Cox regression. The primary exposure variable was six individual and combined 24 H-MG components including the moderated-to-vigorous physical activity, light physical activity, sedentary time, recreational screen time, sleep, and strength training guidelines. All analyses were stratified into two age groups (younger: 20-64 and older adults 65 + years).
Our cross-sectional analyses demonstrated an inverse dose-response relationship between the number of individual 24 H-MG components met and frailty level in adults aged 20-64 (β = -0.439 (95% C.I. = -0.551:-0.328)) and 65+ (β = -0.322 (95% C.I. = -0.490:-0.154)). Of the individual guideline components, following the moderate-to-vigorous physical activity (MVPA) guideline in individuals aged 20-64 and the recreational screen time guideline in adults aged 65 + was associated with lower frailty (p < 0.001). There was no clear prospective relationship between adherence to the combined 24 H-MG and mortality. Of the individual guideline components, only meeting the MVPA guideline component in the 65 + group was prospectively associated with reduced mortality risk (HR = 0.48 (95% C.I. = 0.25-0.93)).
Adherence to the Canadian 24 H-MG may be protective against frailty. Increasing MVPA and decreasing recreational screen time may be important behaviors to consider for frailty prevention and should be investigated further.
坚持加拿大24小时运动指南（24 H-MG）与降低患各种慢性病的风险相关。然而，其与衰弱和全因死亡率的关联尚未得到研究。因此，我们的主要和次要目标分别是研究坚持24 H-MG与衰弱和死亡率之间的关联。
本研究纳入了来自2005 - 2006年国家健康和营养检查调查（NHANES）的2739名个体（年龄 = 50.6 ± 18.1岁；男性 = 1370名（50.0%））。使用46项衰弱指数对衰弱进行量化，并通过线性回归进行横断面分析。全因死亡率数据来自国家死亡指数，并使用Cox回归进行了为期10年的前瞻性分析。主要暴露变量是24 H-MG的六个个体及综合组成部分，包括中度至剧烈身体活动、轻度身体活动、久坐时间、娱乐屏幕时间、睡眠和力量训练指南。所有分析均分为两个年龄组（较年轻组：20 - 64岁和老年人65岁及以上）。
我们的横断面分析表明，在20 - 64岁（β = -0.439（95%置信区间 = -0.551：-0.328））和65岁及以上（β = -0.322（95%置信区间 = -0.490：-0.154））的成年人中，达到的个体24 H-MG组成部分数量与衰弱水平之间存在反向剂量反应关系。在个体指南组成部分中，20 - 64岁个体遵循中度至剧烈身体活动（MVPA）指南以及65岁及以上成年人遵循娱乐屏幕时间指南与较低的衰弱相关（p < 0.001）。坚持综合24 H-MG与死亡率之间没有明确的前瞻性关系。在个体指南组成部分中，只有65岁及以上组达到MVPA指南组成部分与降低死亡率风险具有前瞻性关联（风险比 = 0.48（95%置信区间 = 0.25 - 0.93））。
坚持加拿大24 H-MG可能对衰弱具有保护作用。增加MVPA和减少娱乐屏幕时间可能是预防衰弱需要考虑的重要行为，应进一步研究。
