Physical Activities/Baltimore Longitudinal Study Aging

在过去的几年里，我们研究了巴尔的摩老龄化纵向研究(BLSA)受试者自我报告的体力活动水平。年龄的增长与身体活动、心血管健康、肌肉力量和肌肉质量的下降有关。这些变化导致了老年人的骨质疏松症和虚弱。我们一直感兴趣的是，体力活动的变化如何影响这些其他与活动相关的过程。 在过去的一年里，我们完成了对BLSA受试者自我报告的跌倒的评估。老年人跌倒的特征在文献中被广泛描述，然而关于中年人和年轻人跌倒的报道很少。我们比较了受试者的三个年龄组，年轻的20-45岁，中年(46-65岁)和年龄较大(65岁)的男性和女性。跌倒的报告随着年龄的增长而增加，从年轻人的18%增加到中年人的21%和老年人的35%，女性的发生率高于男性。在所有性别和年龄组中，行走被认为是跌倒的最频繁的原因。70%的受试者报告了某种类型的损伤。年轻组报告的受伤最多的是手腕/手、膝盖和脚踝；中年人受伤最多的是膝盖，老年组受伤最多的是头和膝盖。在所有年龄段中，女性报告的受伤比例都较高。这是我们所知道的第一项比较年轻、中年和老年男性和女性跌倒的研究。三个年龄组之间在跌倒次数、跌倒前从事的活动、跌倒的感知原因和跌倒地点方面存在显著差异。 第二项研究考察了休闲时间体力活动(LTPA)的纵向模式对死亡率的影响。较高的闲暇时间体力活动水平(LTPA)与降低死亡率有关。然而，目前尚不清楚LTPA随时间的变化如何影响所有导致男性和女性死亡的因素。男性(n=1316)和女性(n=776)从BLSA开始，年龄在19-90岁以上，在男性21.2±9.4年和女性10.2±5.6年的平均随访中，在基线和每隔2年评估LTPA。538名男性(40.9%)和90名女性(11.6%)死亡。LTPA是从97项活动中花费的时间的自我报告中得出的，转换为每24小时的Met分钟，并进一步分为高强度LTPA(6 Met)、中等强度LTPA(4-5.9 Met)和低强度LTPA(&lt；4 Met)。在较年轻(70岁)的男性中，那些报告总LTPA改善或可忽略下降的高强度LTPA比那些LTPA下降更大的人全因死亡率更低，这与血清胆固醇、体重指数、高血压和吸烟状况无关。在年龄较大(70岁)的男性中，高强度LTPA的变化率和死亡率之间的关联与年轻男性相似。女性的横断面年龄模式显示，总的、高强度或低强度LTPA的变化率在幸存者或死者之间没有差异；然而，与幸存者相比，年龄较大(70岁)的死者降低了中等强度的LTPA。对于女性，纵向分析表明，总强度、高强度、中强度或低强度LTPA的变化率都不能预测死亡率。在这些注重健康的人群中，总死亡率的纵向下降和高强度的LTPA是男性所有原因死亡率的独立预测因素，而不是女性。在女性中的观察结果与其他研究不一致，可能与低能量有关，因为在随访中女性死亡相对较少。在男性身上的观察表明，保持体力活动水平对长寿很重要。 如何增加体育活动的参与度已成为一个重大的健康问题。答案将在于提供各种允许个性化的课程。目前，一个项目正在进行中，我们正在使用相同的策略，并将其应用于不符合2英里长跑健康要求的预备役军人。目标是通过让他们更清楚自己实际在做什么来提高他们的整体活动水平，并设定合理的目标，在繁忙的日程安排中增加活动。

Over the past several years, we have studied self reported levels of physical activity in the Baltimore Longitudinal Study of Aging (BLSA) subjects. Increasing age is associated with a decline in physical activity, cardiovascular fitness, muscle strength, and muscle mass. These changes contribute to sarcopenia and frailty in the elderly. We have been interested in how changing physical activity impacts on these other activity related processes. Over the past year, we have completed an evaluation of self-reported falls in BLSA subjects. Falls in older people have been characterized extensively in the literature, however little has been reported regarding falls in middle-aged and younger adults. We compared falls in three age groups of subjects, young 20-45 years), middle-aged (46-65 years) and older (>65 years) men and women. The reporting of falls increased with age from 18% in young, to 21% in middle aged and 35% in older adults, with higher rates in women than men. Ambulation was cited as the cause of the fall most frequently in all gender and age groups. An injury of some type was reported in 70% of subjects. The young group reported injuries most frequently to wrist/hand, knees and ankles; the middle-aged to their knees and the older group to their head and knees. Women reported a higher percentage of injuries in all age groups. This is the first study that we are aware of to compare falls in young, middle and older aged men and women. Significant differences were found between the three age groups with respect to number of falls, activities engaged in prior to falling, perceived causes of the fall and where they fell. A second study examined the impact of longitudinal patterns of leisure time physical activity (LTPA) on mortality. Higher levels of leisure time physical activity (LTPA) are associated with reduced mortality. However it is unclear how changes in LTPA over time impact all cause mortality in men and women. Men (n=1316) and women (n=776) aged 19-90+ years from the BLSA were assessed for LTPA at baseline and at ~2 year intervals over a mean follow-up of 21.2 + 9.4 yr for men and 10.2 +5.6 yr for women. Death occurred in 538 men (40.9%) and 90 women (11.6%). LTPA was derived from self-reports of time spent in 97 activities converted into MET-minutes per 24 hours and was further grouped into high (>6 METs), moderate (4-5.9 METs) and low intensity LTPA (<4 METs). In younger (<70 years) men, those who reported improvement or negligible declines in total and high intensity LTPA had lower all cause mortality compared to those with greater declines in LTPA, independent of serum cholesterol, body mass index, hypertension and smoking status. In older (>70 years) men, the association between rate of change in high intensity LTPA and mortality was similar to that seen in younger men. Cross-sectional age patterns for women showed no difference in rates of change in total, high, or low intensity LTPA between survivors or decedents; however older (>70 years) decedents decreased their moderate intensity LTPA as compared to survivors. For women, longitudinal analyses showed neither rates of change in total, high, moderate nor low intensity LTPA were predictive of mortality. In this health-conscious population, greater longitudinal declines in total and high intensity LTPA are independent predictors of all cause mortality in men but not women. The observations in women are not consistent with other studies and may relate to low power due to relatively few deaths in the women over the follow up. The observations in men argue that the maintenance of a physical activity level is important for longevity. How to increase participation in physical activity has become a major health issue. The answer will lie in offering a variety of programs that allow for individualization. At present, a project is underway where we are using the same strategy and applying it to military reservist who do not meet fitness requirements for a 2 mile run. The goal is to increase their overall activity levels by making them more aware of what they are actually performing, and to set reasonable goals to increase activity during the course of their busy schedules.