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预防医学  2024, Vol. 36 Issue (11): 945-949    DOI: 10.19485/j.cnki.issn2096-5087.2024.11.006
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老年人体力活动与死亡的关联研究
张传帝1,2, 斯淑婷3, 余运贤1
1.浙江大学公共卫生学院流行病与卫生统计学系,浙江 杭州 310012;
2.杭州市临平区中西医结合医院,浙江 杭州 311100;
3.义乌市妇幼保健院(浙江大学医学院附属儿童医院义乌分院),浙江 义乌 322000
Association between physical activity and mortality among the elderly
ZHANG Chuandi1,2, SI Shuting3, YU Yunxian1
1. Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Hangzhou, Zhejiang 310012, China;
2. Hangzhou Linping District Integrated Traditional Chinese and Western Medicine Hospital, Hangzhou, Zhejiang 311100, China;
3. Yiwu Maternity and Children Health Hospital (Yiwu Branch of Children's Hospital Affiliated to Zhejiang University School of Medicine), Yiwu, Zhejiang 322000, China
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摘要 目的 探讨老年人体力活动与死亡风险的关系,为指导老年人保持适量的体力活动提供依据。方法 采用回顾性队列研究方法,通过美国国立卫生研究院-美国退休人员协会饮食与健康研究数据库收集50~71岁老年人的基本信息、每周体力活动项目和活动时间等资料;以全因死亡为结局指标,控制人口学、饮食和疾病等因素,采用限制性立方样条模型和多因素Cox比例风险回归模型分析体力活动时间、活动量及不同强度组合模式与全因死亡的关联。结果 收集266 072人资料,年龄为(70.11±5.36)岁,其中男性155 244人,占58.35%;女性110 828人,占41.65%。截至2011年12月31日随访结束,266 072人中全因死亡36 006例。体力活动时间MQR)为14.00(14.00)h/周,体力活动量MQR)为53.00(54.71)MET-h/周。限制性立方样条结果显示,体力活动达到15.0 h/周或50.0 MET-h/周前,全因死亡风险下降较快;但随着体力活动继续增加,全因死亡风险下降趋势变缓(均P<0.05)。多因素Cox比例风险回归分析结果显示,与无体力活动者相比,体力活动时间为0.1~<15.0 h/周、15.0~<29.5 h/周、≥29.5 h/周者(HR=0.502、0.386、0.368)或体力活动量为0.1~<50.0 MET-h/周、50.0~<110.8 MET-h/周、≥110.8 MET-h/周者(HR=0.511、0.379、0.354)的全因死亡风险较低;轻度(0.1~<5.0 h/周)、中度(≥5.0 h/周)和重度(≥1.3 h/周)体力活动组合模式的全因死亡风险较低(HR=0.320)。结论 适量的体力活动与死亡风险降低有关,推荐老年人每周体力活动15.0 h或50.0 MET-h并且结合不同强度。
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张传帝
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关键词 体力活动死亡风险关联回顾性队列研究    
AbstractObjective To investigate the association between physical activity and the risk of mortality, so as to provide the basis for guiding the elderly to maintain appropriate levels of physical activity. Methods A retrospective cohort study was adopted. Basic information, weekly physical activity items and duration of the elderly aged 50-71 years old was collected from the National Institutes of Health-American Association of Retired Persons Diet and Health Study database. With all-cause mortality risk as the main outcome indicator, controlling for demographic, dietary and disease factors, the association between the duration, metabolic equivalent and intensity of physical activity and all-cause mortality risk was analyzed using restricted cubic spline and multivariable Cox proportional risk regression model. Results A total of 266 072 participants were included, with an mean age of (70.11±5.36) years old. There were 155 244 males (58.35%) and 110 828 females (41.65%), with a total of 36 006 deaths by December 31, 2011. The median duration of physical activity was 14.00 (interquartile range, 14.00) h/week and the median metabolic equivalents was 53.00 (interquartile range, 54.71) MET-h/week. Restricted cubic spline analysis indicated that the risk of all-cause mortality declined rapidly within the physical activity range of 0 to 15.0 h/week or 50.0 MET-h/week, but with the continuing increase in physical activity, the decline in the risk of all-cause mortality slowed down (all P<0.05). Multivariable Cox proportional risk regression analysis showed that compared with participants with no physical activity, participants with the duration of 0.1-<15.0 h/week, 15.0-<29.5 h/week, ≥29.5 h/week (HR=0.502, 0.386 and 0.368), or the metabolic equivalent of 0.1-<50.0 MET-h/week, 50.0-<110.8 MET-h/week and ≥110.8 MET-h/week (HR=0.511, 0.379 and 0.354) were associated with a reduced risk of all-cause mortality. The combination of mild (0.1-<5.0 h/week), moderate (≥5.0 h/week) and vigorous (≥1.3 h/week) activities had a lower risk of all-cause mortality (HR=0.320). Conclusion Moderate physical activity is associated with a reduced risk of mortality, and it is recommended to do 15.0 h or 50.0 MET-h of physical activity per week in combination with different intensities.
Key wordsphysical activity    mortality risk    association    retrospective cohort study
收稿日期: 2024-05-29      修回日期: 2024-08-19      出版日期: 2024-11-10
中图分类号:  R339.39  
基金资助:十四五国家重点研发计划项目(2021YFC2701901,2022YFC2703505)
作者简介: 张传帝,硕士研究生在读,主管医师,主要从事公共卫生工作
通信作者: 余运贤,E-mail:yunxianyu@zju.edu.cn   
引用本文:   
张传帝, 斯淑婷, 余运贤. 老年人体力活动与死亡的关联研究[J]. 预防医学, 2024, 36(11): 945-949.
ZHANG Chuandi, SI Shuting, YU Yunxian. Association between physical activity and mortality among the elderly. Preventive Medicine, 2024, 36(11): 945-949.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2024.11.006      或      http://www.zjyfyxzz.com/CN/Y2024/V36/I11/945
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