Role of objectively measured physical activity and sedentary behavior on successful aging: population-based longitudinal study in older adults

体力活动或活动能力作为一般活动的一个主要因素，是国际功能、残疾和健康分类框架中维持或改善社会参与和独立生活的一个主要目标。有强有力的证据表明，经常运动的受试者身体健康水平更高，生活质量更好，患各种慢性病的风险更低，如心血管疾病、糖尿病、癌症，而且随着时间的推移，这与减轻认知和功能衰退密切相关。然而，来自老年人的数据仍然很少，老年人是与此相关的大多数疾病的最高风险，而且他们的体力活动减少最多。此外，缺乏基于重复测量的老年人体力活动和久坐行为轨迹的纵向数据。此外，包括老年人在内的大多数可用大型队列研究都使用回溯性问卷来估计体力活动。特别是重复测量和较长时间的跟踪研究，以便进行敏感性分析，将有助于澄清可能的反向因果关系的问题。Ulm中的老年人活动功能(ActiFE Ulm)研究是一项针对老年人的大型队列研究，具有足够长的随访时间，从一开始就包含了大量基于加速计的体力活动和久坐行为数据。ActiFE Ulm是一项以人群为基础的研究，包括位于德国南部的1506名65岁以上的老年人，在另一次随访中已经看到了这一点。在2012年8月至2013年11月的第一次随访期间，对834名参与者进行了重新评估，包括再次进行为期一周的体力活动、血液样本以及功能、认知和社会评估的传感器测量。这项拟议的前瞻性队列研究的目的现在是描述老年人在七年随访期内的体力活动和久坐行为的轨迹。对身体活动和久坐行为的评估将再次基于客观测量(基于加速计的可穿戴运动检测器，佩戴超过7天)。将分析基线体力活动和久坐行为与各种功能状态指标、跌倒和骨折、与其他发病率(即认知能力下降)、死亡率和特定生物标志物的预后关联。这项研究将进一步确定决定因素以及体力活动和久坐行为模式和轨迹变化的后果。更好地了解这些模式与健康相关的后果将有助于确定潜在的干预目标，并允许对久坐行为和活动的生物标记物进行纵向验证。我们相信，我们的成果将缩小现有的知识差距，并将具有重要的翻译方面。

Physical activity or mobility as a main factor of general activity is a major target in the International classification of Functioning, Disability and Health (ICF) framework to maintain or improve social participation and independent living. Strong evidence exists that physically active subjects have higher levels of physical fitness, better quality of life, and a lower risk for a variety of chronic diseases such as cardiovascular diseases, diabetes, cancer and that it is closely linked to attenuating cognitive and functional decline over time. However, data from older adults, which are at the highest risk for most of the diseases relevant in this context and in whom physical activity declines most, are still sparse. Also, longitudinal data of physical activity and sedentary behaviour trajectories in older persons based on repeated measurements are lacking. Furthermore, most available large cohort studies including older adults have estimated physical activity using retrospective questionnaires. Especially studies with repeated measurements and with longer follow-up which allow performing sensitivity analysis would help to clarify the question of possible reverse causation. The Activity Function in the Elderly in Ulm (ActiFE Ulm) study is a large cohort study in older adults with a sufficiently long follow up that included extensive accelerometer-based data on physical activity and sedentary behavior from the beginning. ActiFE Ulm is a population-based study including n=1506 older people aged 65+ years located in Southern Germany which had already been seen during an additional follow-up. During this first follow-up between August 2012 and November 2013 n=834 participants were reassessed including again a one week sensor measurement of physical activity, blood samples as well as functional, cognitive and social assessments. The objective of this proposed prospective cohort study is now to describe trajectories of physical activity and sedentary behavior in older adults during a seven year follow-up period. The assessment of physical activity and sedentary behavior will be again based on an objective measurement (accelerometer-based wearable motion detectors worn over 7 days). The prognostic association of baseline physical activity and sedentary behavior with various measures of functional status, with falls and fractures, with other morbidity (i.e. cognitive decline), with mortality rates and with specific biomarkers will be analyzed. The study will further allow identifying determinants as well as consequences of changes in physical activity and sedentary behavior patterns and trajectories. A better understanding of the health-related consequences of these patterns will enable identifying potential targets of intervention and allow a longitudinal validation of biomarkers for sedentary behavior and activity. We are confident, that our results will close existing knowledge gaps and will have important translational aspects.