感知邻里环境、久坐行为、步行、中度至剧烈身体活动与衰弱之间的关联：一种等时替代模型。

Association between perceived neighborhood environment, sedentary behavior, walking, and moderate-to-vigorous physical activity and frailty: an isotemporal substitution model.

作者信息

Nam Hee-Kyoung, Won Chang Won, Kim Miji, Cho Sung-Il

机构信息

Department of Public Health Science, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, Republic of Korea.

Department of Family Medicine, Elderly Frailty Research Center, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

出版信息

BMC Geriatr. 2025 Jul 29;25(1):558. doi: 10.1186/s12877-025-06200-4.

DOI:10.1186/s12877-025-06200-4

PMID:40731388

Abstract

INTRODUCTION

With the rapid increases of older population and growing demand for longevity worldwide, frailty has become a major hurdle to sustaining healthy aging. As residential areas are the primary domains of mobility for older adults, the neighborhood environment is a crucial factor for their daily living and physical activity. This study aims to investigate whether replacing sedentary behavior with physical activity and having a supportive neighborhood environment are associated with frailty status in older adults.

METHODS

A cross-sectional analysis was conducted with 2,650 participants aged 70-84 years from the Korean Frailty and Aging Cohort Study (KFACS). The main explanatory variables included self-reported physical activity, sedentary behavior (SB), and perceived neighborhood environment. Frailty as the response variable was defined using the Fried frailty phenotype. Multinomial regression was performed to analyze the outcome. The Isotemporal Substitution Model (ISM) was applied to examine the effects of replacing sedentary behavior with physical activity.

RESULTS

The frailty status of participants was categorized as 45.3% robust, 47.3% pre-frail, and 7.6% frail. Accessibility factor was associated with a decreased risk of being pre-frail (odds ratio (OR): 0.750, 95% CI: 0.673-0.836) and frail (OR: 0.654, 95% CI: 0.541-0.789) compared to being robust. According to ISM, substituting 10 min of SB with any type of physical activity was associated with a reduced risk of pre-frailty [if 10 min of SB was replaced by 10 min of walking (OR: 0.972, CI: 0.960-0.985)] and frailty [if 10 min of SB was replaced by MVPA (OR: 0.877, CI: 0.836-0.921); or by walking (OR: 0.852, CI: 0.814-0.891)].

CONCLUSIONS

Replacing SB with walking and improving neighborhood accessibility were significantly associated with reduced risk of being pre-frail or frail. These findings highlight the importance of considering these factors when designing age-friendly environments for older adults.

摘要

引言

随着全球老年人口的迅速增加以及对长寿的需求不断增长，衰弱已成为维持健康老龄化的主要障碍。由于居住区是老年人主要的活动区域，邻里环境是影响他们日常生活和身体活动的关键因素。本研究旨在调查用体育活动替代久坐行为以及拥有支持性的邻里环境是否与老年人的衰弱状态相关。

方法

对来自韩国衰弱与老龄化队列研究（KFACS）的2650名70 - 84岁参与者进行了横断面分析。主要解释变量包括自我报告的体育活动、久坐行为（SB）和感知到的邻里环境。以Fried衰弱表型定义作为响应变量的衰弱。进行多项回归分析结果。应用等时替代模型（ISM）来检验用体育活动替代久坐行为的效果。

结果

参与者的衰弱状态分类为：45.3%为健康，47.3%为衰弱前期，7.6%为衰弱。与健康状态相比，可达性因素与衰弱前期风险降低相关（优势比（OR）：0.750，95%置信区间：0.673 - 0.836）以及与衰弱风险降低相关（OR：0.654，95%置信区间：0.541 - 0.789）。根据ISM，用任何类型的体育活动替代10分钟的久坐行为与衰弱前期风险降低相关[如果10分钟的久坐行为被10分钟的步行替代（OR：0.972，CI：0.960 - 0.985）]以及与衰弱风险降低相关[如果10分钟的久坐行为被中等强度身体活动（MVPA）替代（OR：0.877，CI：0.836 - 0.921）；或被步行替代（OR：0.852，CI：0.814 - 0.891）]。