Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study
Physical capability in mid-life and survival over 13 years of follow-up: British birth cohort study
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DOI：
10.1136/bmj.g2219
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发表时间：
2014-04-29
影响因子：
105.7
通讯作者：
Kuh, Diana
中科院分区：
文献类型：
--
作者：
Cooper, Rachel;Strand, Bjorn Heine;Kuh, Diana
目的研究53岁时评估的三种常用的体能客观指标与这些指标的综合评分和全因死亡率之间的关系;研究不能进行这些检查是否与死亡率相关。设计队列研究。设置MRC国家健康与发展调查，在英格兰，苏格兰，和威尔士。参与者1355名男性和1411名女性，年龄为53岁，身体能力数据与国家卫生服务（NHS）中央登记死亡通知。主要结果测量年龄53（1999）和66（2012）之间的全因死亡率。结果对于身体能力的三个指标（握力、椅子上升速度和站立平衡时间）中的每一个，无法进行测试的参与者和表现最差的五分之一的参与者的死亡率都高于表现最好的五分之一的参与者。基线协变量调整部分减弱了相关性，但在完全调整的模型中，主要相关性仍然存在。例如，体能综合评分最低与最高五分之一的全因死亡率的完全校正风险比为3.68（95%置信区间为2.03至6.68）。那些不能进行任何测试的人与那些能够进行所有三项测试的人相比，死亡率要高得多（8.40，4.35至16.23）。当一系列的模型，包括不同的组合的措施进行了比较，通过使用似然比检验，所有三个措施的身体能力，以提高模型拟合，和模型，包括所有三个措施产生的预测能力的最高估计（哈勒尔的C指数0.71，95%置信区间0.65至0.77）。有一些证据表明，站立平衡时间与死亡率比其他两个measurement.Conclusions较低水平的体能在53岁，无法进行能力测试与较高的死亡率。即使在这个相对年轻的年龄，这些措施也确定了那些比其他人更不可能实现长寿和健康生活的人群。
Objectives To examine associations between three commonly used objective measures of physical capability assessed at age 53 and a composite score of these measures and all cause mortality; to investigate whether being unable to perform these tests is associated with mortality.Design Cohort study.Setting MRC National Survey of Health and Development in England, Scotland, and Wales.Participants 1355 men and 1411 women with data on physical capability at age 53 who were linked to the National Health Service (NHS) central register for death notification.Main outcome measure All cause mortality between ages 53 (1999) and 66 (2012).Results For each of the three measures of physical capability (grip strength, chair rise speed, and standing balance time) those participants unable to perform the test and those in the lowest performing fifth were found to have higher mortality rates than those in the highest fifth. Adjustment for baseline covariates partially attenuated associations but in fully adjusted models the main associations remained. For example, the fully adjusted hazard ratio of all cause mortality for the lowest compared with the highest fifth of a composite score of physical capability was 3.68 (95% confidence interval 2.03 to 6.68). Those people who could not perform any of the tests had considerably higher rates of death compared with those people able to perform all three tests (8.40, 4.35 to 16.23). When a series of models including different combinations of the measures were compared by using likelihood ratio tests, all three measures of physical capability were found to improve model fit, and a model including all three measures produced the highest estimate of predictive ability (Harrell's C index 0.71, 95% confidence interval 0.65 to 0.77). There was some evidence that standing balance time was more strongly associated with mortality than the other two measures.Conclusions Lower levels of physical capability at age 53 and inability to perform capability tests are associated with higher rates of mortality. Even at this relatively young age these measures identify groups of people who are less likely than others to achieve a long and healthy life.