A Case for Promoting Movement Medicine: Preventing Disability in the LIFE Randomized Controlled Trial
A Case for Promoting Movement Medicine: Preventing Disability in the LIFE Randomized Controlled Trial
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DOI：
10.1093/gerona/glz050
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发表时间：
2019-11-01
影响因子：
5.1
通讯作者：
Miller, Michael E.
中科院分区：
文献类型：
--
作者：
Fanning, Jason;Rejeski, W. Jack;Miller, Michael E.
背景资料：功能受损的老年人的运动特征尚不清楚，这些特征与严重活动障碍（MMD）发展之间的关系也是未知的-这是一个关键的临床结局。我们首先描述的尺寸的运动在老年人的功能受损，然后检查这些尺寸是否预测MMD.Methods的发病：老年人在MMDs（N = 1,022，平均年龄= 78.7岁）的风险随机接受结构化的体力活动干预或健康教育控制。我们评估MMD在6个月的时间间隔（平均随访2.2年，直到事件MMD），与活动评估在基线，6-，12-和24个月的后续通过accelerometer.Results：11个加速度计衍生指标的主成分分析产生了三个组成部分，代表生活方式运动（LM），延长中度到剧烈的体力活动（MVPA），和静止的身体姿势。LM占运动变异的最大比例（53%）。在健康教育中，基线LM（HR = 0.74; 95% CI 0.62 - 0.88）和中度至剧烈体力活动（HR = 0.69; 95% CI 0.54 - 0.87）均与MMD相关，而在体力活动中，仅LM与MMD相关（HR = 0.74; 95% CI 0.61 - 0.89）。在体力活动和健康教育中，LM也存在类似的非线性关系（p < .04），因此LM水平较高的个体MMD风险较低。结论：LM和中度至剧烈的体力活动都应该是老年人MMD风险治疗方案的核心。
Background: The movement profile of older adults with compromised function is unknown, as is the relationship between these profiles and the development of major mobility disability (MMD)-a critical clinical outcome. We first describe the dimensions of movement in older adults with compromised function and then examine whether these dimensions predict the onset of MMD.Methods: Older adults at risk for MMD (N = 1,022, mean age = 78.7 years) were randomized to receive a structured physical activity intervention or health education control. We assessed MMD in 6-month intervals (average follow-up of 2.2 years until incident MMD), with activity assessed at baseline, 6-, 12- and 24-month follow-up via accelerometry.Results: A principal components analysis of 11 accelerometer-derived metrics yielded three components representing lifestyle movement (LM), extended bouts of moderate-to-vigorous physical activity (MVPA), and stationary body posture. LM accounted for the greatest proportion of variance in movement (53%). Within health education, both baseline LM (HR = 0.74; 95% CI 0.62 to 0.88) and moderate-to-vigorous physical activity (HR = 0.69; 95% CI 0.54 to 0.87) were associated with MMD, whereas only LM was associated with MMD within physical activity (HR = 0.74; 95% CI 0.61 to 0.89). There were similar nonlinear relationships present for LM in both physical activity and health education (p < .04), whereby risk for MMD was lower among individuals with higher levels of LM.Conclusions: Both LM and moderate-to-vigorous physical activity should be central in treatment regimens for older adults at risk for MMD.