Relationship of changes in physical activity and mortality among older women
Relationship of changes in physical activity and mortality among older women
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DOI：
10.1001/jama.289.18.2379
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发表时间：
2003-05-14
影响因子：
120.7
通讯作者：
Ensrud, KE
中科院分区：
文献类型：
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作者：
Gregg, EW;Cauley, JA;Ensrud, KE
体育活动与降低死亡率有关，但尚不清楚体育活动的变化是否会影响老年妇女的死亡率。目的探讨老年妇女体力活动变化与死亡率的关系。设计、环境和参与者在美国4个研究中心（马里兰州巴尔的摩、俄勒冈州波特兰、明尼苏达州明尼阿波利斯和宾夕法尼亚州莫农加赫拉谷）对9518名65岁及以上的社区白人妇女进行了前瞻性队列研究，这些妇女在基线（1986-1988年）进行了评估，其中7553人在随访（1992-1994年，中位，5.7年后）时进行了重新评估。基线和随访时的步行和其他身体活动；生命状态，死亡原因由死亡证明/出院摘要确认，在基线后最长追踪12.5年（随访后最长追踪6.7年）。结果与持续久坐不动的女性相比，在基线和随访期间增加体力活动水平的女性具有较低的全因死亡率（危险率比[HRR]， 0.52； 95%可信区间[CI]， 0.40-0.69）、心血管疾病（HRR, 0.64; 95% CI, 0.42-0.97）和癌症（HRR, 0.49; 95% CI, 0.29-0.84），与年龄、吸烟、体重指数、共病条件和基线体力活动水平无关。在患有和不患有慢性病的妇女中，体力活动的变化与降低死亡率之间的联系相似，但在75岁以上的妇女和健康状况不佳的妇女中，这种联系往往较弱。与久坐不动的女性相比，两次就诊时进行体力活动的女性的全因死亡率（HRR, 0.68; 95% CI, 0.56-0.82）和心血管死亡率（HRR, 0.62; 95% CI, 0.44-0.88）也较低。结论：增加并保持体力活动水平可以延长老年妇女的寿命，但对75岁以上和健康状况不佳的妇女似乎效果不大。
Context Physical activity has been related to reduced mortality, but it is not clear whether changes in physical activity affect mortality among older women.Objective To examine the relationship of changes in physical activity and mortality among older women.Design, Setting, and Participants Prospective cohort study conducted at 4 US research centers (Baltimore, Md; Portland, Ore; Minneapolis, Minn; and Monongahela Valley, Pa) among 9518 community-dwelling white women aged 65 years or older who were assessed at baseline (1986-1988), 7553 of whom were reassessed at a follow-up visit (1992-1994; median,5.7 years later).Main Outcome Measures Walking and other physical activities at baseline and follow-up; vital status, with cause of death confirmed by death certificates/discharge summaries, tracked for up to 12.5 years after baseline (up to 6.7 years after the follow-up visit).Results Compared with continually sedentary women, those who increased physical activity levels between baseline and follow-up had lower mortality from all causes (hazard rate ratio [HRR], 0.52; 95% confidence interval [CI], 0.40-0.69), cardiovascular disease (HRR, 0.64; 95% CI, 0.42-0.97), and cancer (HRR, 0.49; 95% CI, 0.29-0.84), independent of age, smoking, body mass index, comorbid conditions, and baseline physical activity level. Associations between changes in physical activity and reduced mortality were similar in women With and without chronic diseases but tended to be weaker among women aged at least 75 years and among those with poor health status. Women who were physically active at both visits also had lower all-cause mortality (HRR, 0.68; 95% CI, 0.56-0.82) and cardiovascular mortality (HRR, 0.62; 95% CI, 0.44-0.88) than sedentary women.Conclusion Increasing and maintaining physical activity levels could lengthen life for older women but appears to provide less benefit for women aged at least 75 years and those with,poor health status.