Is there a U-shaped association between physical activity and falling in older persons?
Is there a U-shaped association between physical activity and falling in older persons?
复制标题
DOI：
10.1007/s00198-009-1053-4
复制
发表时间：
2010-07-01
影响因子：
4
通讯作者：
Lips, P.
中科院分区：
文献类型：
--
作者：
Peeters, G. M. E. E.;van Schoor, N. M.;Lips, P.
这项研究测试了体力活动和（经常性）跌倒之间的关系是否呈 U 形。在 1,337 名社区老年人中，没有发现非线性关联的证据。如果所有老年人增加100个单位的体力活动水平，则可以防止4%的人经常跌倒。之前的研究表明，体力活动与跌倒之间存在U形关系。本研究测试了这一假设，并检验了这种关系是否会因身体机能水平而改变。阿姆斯特丹纵向老龄化研究 (LASA) 的社区居民 (65 岁以上) 在 1995/1996 年基线评估后对跌倒情况进行了为期 3 年的前瞻性跟踪 (n = 1,337)。结果指标是首次跌倒的时间和反复跌倒的时间。 LASA 体力活动问卷用于计算每天的体力活动分钟数，加权强度（范围 0-2000）。身体功能通过身体表现测试和自我报告的功能限制来测量。混杂因素包括年龄、性别、体重指数、慢性疾病、精神药物、认知功能、抑郁症状和对跌倒的恐惧。没有发现非线性关联的证据（体力活动 p(2) > 0.20）。体力活动与首次跌倒时间之间没有发现显着关联。增加 100 单位的体力活动可使反复跌倒的风险降低 4%（调整后的风险比为 0.96，95% 置信区间为 0.92、0.99）。未发现与身体表现或功能限制之间的相互作用 (p > 0.50)。身体活动与跌倒之间假设的 U 形关系无法得到证实。在较高水平的体力活动下，反复跌倒的风险降低，但未发现与跌倒风险之间的关联。
This study tests whether the relationship between physical activity and (recurrent) falling is U-shaped. Among 1,337 community-dwelling older persons, no evidence for a nonlinear association was found. If all older persons increase their physical activity level with 100 units, 4% may be prevented to become recurrent fallers.Previous studies suggest a U-shaped relationship between physical activity and falling. This study tests this hypothesis and examines whether this relationship is modified by level of physical functioning.Community-dwelling persons (65+) from the Longitudinal Aging Study Amsterdam (LASA) were prospectively followed on falls for 3 years after baseline assessment in 1995/1996 (n = 1,337). Outcome measures were time to first fall and time to recurrent falling. The LASA Physical Activity Questionnaire was used to calculate physical activity in minutes per day weighted for intensity (range 0-2000). Physical functioning was measured with physical performance tests and self reported functional limitations. Confounders were age, sex, body mass index, chronic diseases, psychotropic medication, cognitive functioning, depressive symptoms, and fear of falling.No evidence for a nonlinear association was found (p for physical activity(2) > 0.20). No significant association was found between physical activity and time to first fall. An increase in physical activity of 100 units led to a 4% decrease in risk of recurrent falling (adjusted hazard ratio 0.96, 95% confidence interval 0.92, 0.99). No interactions with physical performance or functional limitations were found (p > 0.50).The hypothesized U-shaped relationship between physical activity and falling could not be confirmed. At higher levels of physical activity, the risk of recurrent falling decreased, while no association was found with fall risk.