Physical Activity and Falls in Older Men: The Critical Role of Mobility Limitations.
Physical Activity and Falls in Older Men: The Critical Role of Mobility Limitations.
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DOI：
10.1249/mss.0000000000000635
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发表时间：
2015-10
影响因子：
4.1
通讯作者：
Whincup PH
中科院分区：
文献类型：
--
作者：
Jefferis BJ;Merom D;Sartini C;Wannamethee SG;Ash S;Lennon LT;Iliffe S;Kendrick D;Whincup PH
补充数字内容可在文本中找到。体力活动（PA）有许多健康益处，但可能增加老年人的福尔斯风险。我们研究如何客观地测量习惯性日常PA是相关的福尔斯通过探索的修改效果的移动性限制和调解作用的健身和下肢力量。在一项正在进行的基于英国人群的队列研究中，3137名存活受试者（男性，年龄71-91岁）中有1655名（53%）在2010-2012年期间在髋关节上佩戴ActiGraph GT 3x加速计1周，以测量PA（暴露）并报告人口统计学和健康状况，包括活动受限。一年后，825名男性报告了福尔斯病史（结局）。825名男性中有700人的加速度计佩戴≥600 min·d−1 ≥3 d。19%（n = 128）报告1年后发生福尔斯跌倒。PA和福尔斯之间的关联因活动受限的存在而不同。在66%（n = 471）无活动受限的男性中，福尔斯次数递增（每30分钟中度至剧烈PA [MVPA]：发生率比[IRR]，1.50; 95%置信区间[CI]，1.10-2.03，校正福尔斯风险因素）。步数与每天低于9000步的福尔斯跌倒次数无关，但与每天≥9000步的福尔斯跌倒次数相关（每天每增加1000步：IRR，1.59; 95% CI，1.16-2.18）。在33%（n = 229）的活动受限男性中，福尔斯风险随着活动量的增加而降低（每天每1000步：IRR，0.80; 95% CI，0.70-0.91; MVPA每30分钟：IRR，0.61; 95% CI，0.42-0.89;久坐行为每增加30分钟≥600 min·d−1：IRR，1.22; 95% CI，1.07-1.40）。促进老年男性MVPA的干预措施应包括福尔斯预防策略。在行动不便的成年人中，试验应该调查增加MVPA水平是否可以降低福尔斯风险。
Supplemental digital content is available in the text. Physical activity (PA) has many health benefits but may increase falls risk among older adults. We study how objectively measured habitual daily PA is related to falls by exploring the modifying effect of mobility limitations and the mediating roles of fitness and lower-limb strength. One thousand six hundred fifty-five (53%) of 3137 surviving participants (men age 71–91 yr) in an ongoing UK-population-based cohort study wore an ActiGraph GT3x accelerometer over the hip for 1 wk in 2010–2012 to measure PA (exposure) and reported demographic and health status, including mobility limitations. One year later, 825 men reported falls history (outcome). Seven hundred of 825 men had ≥600 min·d−1 of accelerometer wear for ≥3 d. Nineteen percent (n = 128) reported falls 1 yr later. Associations between PA and falls differed by presence of mobility limitations. Among 66% (n = 471) of men without mobility limitations, number of falls increased incrementally (for every 30 min of moderate to vigorous PA [MVPA]: incidence rate ratio [IRR], 1.50; 95% confidence interval [CI], 1.10–2.03, adjusted for falls risk factors). Step count was not related to number of falls below 9000 steps per day but was related to number of falls ≥9000 steps per day (for every additional 1000 steps per day: IRR, 1.59; 95% CI, 1.16–2.18). Among 33% (n = 229) of men with mobility limitations, falls risk declined with increasing activity (for every 1000 steps per day: IRR, 0.80; 95% CI, 0.70–0.91; for every 30 min of MVPA: IRR, 0.61; 95% CI, 0.42–0.89; for every additional 30 min of sedentary behavior ≥600 min·d−1: IRR, 1.22; 95% CI, 1.07–1.40). Interventions to promote MVPA in older men should incorporate falls prevention strategies. Among adults with mobility limitations, trials should investigate whether increasing MVPA levels can reduce falls risk.