Fries J F, Singh G, Morfeld D, Hubert H B, Lane N E, Brown B W
Stanford University School of Medicine, California.
Ann Intern Med. 1994 Oct 1;121(7):502-9. doi: 10.7326/0003-4819-121-7-199410010-00005.
To determine, by longitudinal study, whether regular vigorous running activity is associated with accelerated, unchanged, or postponed development of disability with increasing age.
8-year prospective, longitudinal study with yearly assessments.
451 members of a runners' club and 330 community controls who were initially 50 to 72 years old (also characterized as "ever-runners" [n = 534] and "never-runners" [n = 247], respectively).
The dependent variable was disability as assessed by the Health Assessment Questionnaire and separately validated in these participant cohorts. Covariates included age, sex, body mass index, comorbid conditions, education level, smoking history, alcohol intake, mean blood pressure, initial disability level, family history of arthritis, and radiologic evidence of osteoarthritis of the knee in a subsample.
Initially, the runners were leaner, reported joint symptoms less frequently, took fewer medications, had fewer medical problems, and had fewer instances of and less severe disability, suggesting either that the average previous 12 years of running had improved health or that self-selection bias was present. After 8 years of longitudinal study, the differences in initial disability levels (0.026 compared with 0.079; P < 0.001) had steadily increased to 0.071 for runners compared with 0.242 for controls (P < 0.001). The difference was consistent for men and women. The rate of development of disability was several times lower in the runners' club members than in community controls; this difference persisted after adjusting for age, sex, body mass, baseline disability, smoking history, history of arthritis, or other comorbid conditions (slopes of progression of disability for the years 1984 to 1992, after adjusting for covariates: men in the runners' club, 0.004 [SE, 0.002]; community controls, 0.012 [SE, 0.002]; women in the runners' club, 0.009 [SE, 0.005]; community controls, 0.027 [SE, 0.004]; P < 0.002 for both sets of comparisons). In addition to differences in disability, there were significant differences in mortality between the runners' club members (1.49%) and community controls (7.09%) (P < 0.001). These differences remained significant after adjusting for age, sex, body mass, comorbid conditions, education level, smoking history, alcohol intake, and mean blood pressure (P < 0.002, conditional risk ratio for community controls compared with the runners, 4.27; 95% CI, 1.78 to 10.26).
Older persons who engage in vigorous running and other aerobic activities have lower mortality and slower development of disability than do members of the general population. This association is probably related to increased aerobic activity, strength, fitness, and increased organ reserve rather than to an effect of postponed osteoarthritis development.
通过纵向研究确定，随着年龄增长，规律的剧烈跑步活动是否与残疾发展加速、不变或延迟相关。
为期8年的前瞻性纵向研究，每年进行评估。
一个跑步俱乐部的451名成员和330名社区对照者，他们最初年龄在50至72岁（分别也被称为“曾经跑步者”[n = 534]和“从不跑步者”[n = 247]）。
因变量是通过健康评估问卷评估的残疾情况，并在这些参与者队列中分别进行了验证。协变量包括年龄、性别、体重指数、合并症、教育水平、吸烟史、饮酒量、平均血压、初始残疾水平、关节炎家族史以及一个子样本中膝关节骨关节炎的放射学证据。
最初，跑步者更瘦，报告关节症状的频率更低，服用药物更少，有更少的医疗问题，残疾情况的发生次数更少且程度更轻，这表明要么之前平均12年的跑步改善了健康状况，要么存在自我选择偏差。经过8年的纵向研究，跑步者与对照者相比，初始残疾水平的差异（0.026比0.079；P < 0.001）稳步扩大，跑步者为0.071，对照者为0.242（P < 0.001）。男性和女性的差异一致。跑步俱乐部成员的残疾发展速率比社区对照者低几倍；在调整年龄、性别、体重、基线残疾、吸烟史、关节炎病史或其他合并症后，这种差异仍然存在（1984年至1992年调整协变量后残疾进展斜率：跑步俱乐部男性，0.004[标准误，0.002]；社区对照者，0.012[标准误，0.002]；跑步俱乐部女性，0.009[标准误，0.005]；社区对照者，0.027[标准误，0.004]；两组比较P均< 0.002）。除了残疾差异外，跑步俱乐部成员（1.49%）和社区对照者（7.09%）之间的死亡率也存在显著差异（P < 0.001）。在调整年龄、性别、体重、合并症、教育水平、吸烟史、饮酒量和平均血压后，这些差异仍然显著（与跑步者相比，社区对照者的条件风险比为4.27；95%可信区间，1.78至10.26；P < 0.002）。
从事剧烈跑步和其他有氧运动的老年人比一般人群的死亡率更低，残疾发展更慢。这种关联可能与有氧运动增加、力量增强、身体适应性提高以及器官储备增加有关，而不是与骨关节炎发展延迟的影响有关。
