Characterising patterns and changes in physical activity in older people and their determinants and consequences

糖尿病、心脏病、癌症和精神健康问题等非传染性疾病占全球死亡人数的60%。不良的饮食习惯和缺乏体育锻炼是增加患这些疾病几率的重要因素。据估计，全球约十分之一的死亡是由缺乏身体活动造成的，与吸烟的影响相当。面对这些统计数据，每个人都应该努力做出个人选择，采取积极的生活方式，这似乎是直觉。然而，我们并不是孤立地做出这种选择，我们的活动水平被认为不仅受到我们个人知识、态度和信仰的影响，也受到我们生活的更广泛的社会、文化、经济和自然环境的影响。在可预见的未来，保健服务和社会将面临的主要挑战之一是照顾无法独立生活的老年人。在中老年人中推广体育活动可能会使这一挑战更容易应对。不幸的是，大多数关于身体活动水平和模式、为什么有些人比其他人更活跃以及身体活动与健康结果之间的联系的研究都是在60岁以下的个体中进行的，并且依赖于不精确的问卷调查。我们现有的科学家合作包括从公共卫生和流行病学、卫生地理学和卫生经济学到社会和行为科学等一系列学科的专业知识。作为国家公共卫生卓越中心CEDAR（饮食和活动研究卓越中心）的一部分，我们已经有效地合作了几年。CEDAR是剑桥医学研究委员会（MRC）、剑桥大学、东安格利亚大学（UEA）和包括东英格兰公共卫生观察站（ERPHO）在内的非学术合作伙伴之间的合作项目。该中心在人口层面研究饮食和活动的决定因素，并制定和评估潜在的预防性干预措施（见http://www.cedar.iph.cam.ac.uk/）.We)，在慢性病的起因、身体活动及其测量以及制定和评估促进疾病高风险个人进行身体活动的干预措施方面具有专门知识。我们还获得了参与EPIC-Norfolk研究的大量老年人样本。在这个项目中，我们将描述身体活动的水平和模式，以及久坐行为（如看电视）。我们将在EPIC-Norfolk研究中使用志愿者的自我报告和客观测量来研究这些行为是如何随时间变化的。我们还将提高对以下方面的认识：可能降低疾病风险并对老年人可行的各种活动，影响老年人身体活动的个人和环境因素，以及身体活动的变化在多大程度上可能降低疾病风险和保健服务成本。这些都是制定干预措施和政策以帮助人们采取可持续健康行为的重要步骤。为了实现我们的目标，我们将在一项正在进行的大型研究的背景下使用一系列定量和定性研究方法。我们收集的证据将有助于政治家、卫生专业人员和整个社会就如何改善全体人口的健康做出更好的决定，无论是通过直接的公共卫生干预，还是通过影响我们生活方式的更广泛的方式。它还将帮助科学家和研究资助者把精力集中在通过进一步研究减少不确定性将提供最大利益的领域。

Non-communicable diseases such as diabetes, heart disease, cancer and mental health problems account for 60% of deaths globally. Poor diet and lack of physical activity play an important role in increasing the chance of developing these diseases. Physical inactivity is estimated to account for around 1 in 10 deaths worldwide, comparable to the impact of smoking. In the face of these statistics it would seem intuitive that everyone should strive to make individual choices to adopt an active lifestyle. However, we do not make such choices in isolation and our activity levels are believed to be driven as much by the broader social, cultural, economic and physical environment in which we live by as our personal knowledge, attitudes and beliefs.One of the main challenges that will face health services, and society, in the foreseeable future is the care of older people with limitations to their independent living. The promotion of physical activity among the middle-aged and elderly may make this challenge more manageable. Unfortunately, the majority of research on levels and patterns of physical activity, why some people are more active than others, and the links between physical activity and health outcomes has been undertaken among individuals less than 60 years of age, and has relied on imprecise questionnaire measures.Our existing collaboration of scientists includes expertise in a range of disciplines from Public Health and Epidemiology, Health Geography and Health Economics to Social and Behavioural Science. We have worked effectively together for several years as part of a national Public Health Centre of Excellence called CEDAR (Centre of Excellence in Diet and Activity Research). CEDAR is a collaboration between Medical Research Council (MRC) Units in Cambridge, the University of Cambridge, the University of East Anglia (UEA) and non-academic partners including the East of England Public Health Observatory (ERPHO). CEDAR researches the determinants of diet and activity at the population level and develops and evaluates potential preventive interventions (see http://www.cedar.iph.cam.ac.uk/).We have expertise in the causes of chronic disease, in physical activity and its measurement and in the development and evaluation of interventions to promote physical activity among individuals with or at high risk of disease. We also have access to a large population-based sample of older people participating in the EPIC-Norfolk study. In this project we will describe the levels and patterns of physical activity and also of sedentary behaviour (such as television viewing). We will study how these behaviours change over time using self-report and objective measures among volunteers in the EPIC-Norfolk study. We will also improve knowledge about the sorts of activities that might reduce risk of disease and be feasible for older people, the personal and environmental factors that influence physical activity in older people, and to what extent changes in physical activity might reduce disease risk and health service costs. These are important steps in developing interventions and policy to help populations adopt sustainable healthy behaviours.In order to achieve our aims we will use a range of quantitative and qualitative research methods within the context of a large ongoing study. The evidence we gather will help politicians, health professionals and society at large make better decisions about how to improve health for the whole population, whether it is through direct public health interventions, or wider ways that influence how we live. It will also help scientists and research funders to focus efforts into areas in which reducing uncertainty through further research would provide the greatest benefit.