Accelerated longitudinal decline of aerobic capacity in healthy older adults
Accelerated longitudinal decline of aerobic capacity in healthy older adults
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DOI：
10.1161/circulationaha.105.545459
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发表时间：
2005-08-02
期刊：
影响因子：
37.8
通讯作者：
Lakatta, EG
中科院分区：
文献类型：
--
作者：
Fleg, JL;Morrell, CH;Lakatta, EG
背景——老年人独立活动的能力在很大程度上取决于维持足够的有氧能力和力量来进行日常活动。尽管人们普遍认为峰值有氧能力会随着年龄的增长而下降，但其下降率主要是根据横断面研究来估计的，这些研究可能会对衰老变化提供误导性的、过于乐观的估计。方法和结果 - 为了确定有氧能力的纵向变化率以及年龄、性别和体力活动对这些变化的影响，我们对 375 年的跑步机耗氧量峰值（峰值 V.O-2）进行了系列测量。 巴尔的摩老龄化纵向研究（一项没有临床心脏病的社区居住队列）对年龄在 21 至 87 岁的女性和 435 名男性进行了研究，中位随访期为 7.9 年。使用线性混合效应回归模型计算 20 多岁至 70 多岁每个年龄段的峰值 V.O-2 的预测纵向 10 年变化率（以毫升每分钟表示），并根据自我报告的休闲时间体力活动进行调整。在男女的 6 个年龄段中，每个年龄段的峰值 V.O2 均出现纵向下降；然而，下降速度从20世纪20年代和30年代每10年3%至6%加速到70年代及以后每10年>20%。从 40 岁开始，每十年男性的下降速度都大于女性。当每公斤体重或每公斤去脂体重以及自我报告的休闲时间体力活动的所有四分位数中对峰值摄氧量进行指数化时，类似的纵向下降率普遍存在。当检查峰值 V.O2 的组成部分时，氧脉冲的纵向下降率（即每次心跳的 O-2 利用率）与峰值 V.O2 的纵向下降率相同，而心率纵向下降率平均每 10 年仅 4% 至 6%，并且随着年龄的增长仅略有加速。结论 - 健康成人峰值 V.O2 的纵向下降率在整个过程中并不是恒定的。 正如横断面研究所假设的那样，健康人的年龄跨度随着年龄的增长而显着加快，尤其是男性，无论体育活动习惯如何。峰值有氧能力的加速下降对功能独立性和生活质量具有重大影响，不仅对健康老年人，而且特别是当疾病相关缺陷叠加时。
Background - The ability of older persons to function independently is dependent largely on the maintenance of sufficient aerobic capacity and strength to perform daily activities. Although peak aerobic capacity is widely recognized to decline with age, its rate of decline has been estimated primarily from cross-sectional studies that may provide misleading, overly optimistic estimates of aging changes.Methods and Results - To determine longitudinal rate of change in aerobic capacity and the influence of age, gender, and physical activity on these changes, we performed serial measurements of peak treadmill oxygen consumption ( peak V. O-2) in 375 women and 435 men ages 21 to 87 years from the Baltimore Longitudinal Study of Aging, a community-dwelling cohort free of clinical heart disease, over a median follow-up period of 7.9 years. A linear mixed-effects regression model was used to calculate the predicted longitudinal 10-year rate of change in peak V. O-2, expressed in milliliters per minute, for each age decade from the 20s through the 70s after adjustment for self-reported leisure-time physical activity. A longitudinal decline in peak V. O2 was observed in each of the 6 age decades in both sexes; however, the rate of decline accelerated from 3% to 6% per 10 years in the 20s and 30s to > 20% per 10 years in the 70s and beyond. The rate of decline for each decade was larger in men than in women from the 40s onward. Similar longitudinal rates of decline prevailed when peak V. O2 was indexed per kilogram of body weight or per kilogram of fat-free mass and in all quartiles of self-reported leisure-time physical activity. When the components of peak V. O2 were examined, the rate of longitudinal decline of the oxygen pulse ( ie, the O-2 utilization per heart beat) mirrored that of peak V. O2, whereas the longitudinal rate of heart rate decline averaged only 4% to 6% per 10 years, and accelerated only minimally with age.Conclusions - The longitudinal rate of decline in peak V. O2 in healthy adults is not constant across the age span in healthy persons, as assumed by cross-sectional studies, but accelerates markedly with each successive age decade, especially in men, regardless of physical activity habits. The accelerated rate of decline of peak aerobic capacity has substantial implications with regard to functional independence and quality of life, not only in healthy older persons, but particularly when disease-related deficits are superimposed.