体力活动、伤害性跌倒与老年人身体机能：伞式综述
Physical Activity, Injurious Falls, and Physical Function in Aging: An Umbrella Review.
机构信息
Milken Institute School of Public Health, The George Washington University, Washington, DC.
Department of Nutrition Science, Purdue University, West Lafayette, IN.
出版信息
Med Sci Sports Exerc. 2019 Jun;51(6):1303-1313. doi: 10.1249/MSS.0000000000001942.
PURPOSE
To review and update the evidence of the relationship between physical activity, risk of fall-related injury, and physical function in community-dwelling older people that was presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (PAGAC Report).
METHODS
Duplicate independent screenings of 1415 systematic reviews and meta-analyses published between 2006 and 2016 identified from PubMed®, Cochrane Library, and CINAHL databases yielded 111 articles used for the PAGAC Report. The PAGAC Aging Subcommittee members graded scientific evidence strength based upon a five-criteria rubric and assigned one of four grades: strong, moderate, limited, or not assignable. An updated search of 368 articles published between January 2017 and March 2018 yielded 35 additional pertinent articles.
RESULTS
Strong evidence demonstrated that physical activity reduced the risk of fall-related injuries by 32% to 40%, including severe falls requiring medical care or hospitalization. Strong evidence also supported that physical activity improved physical function and reduced the risk of age-related loss of physical function in an inverse graded manner among the general aging population, and improved physical function in older people with frailty and with Parkinson's disease. Aerobic, muscle-strengthening, and/or multicomponent physical activity programs elicited the largest improvements in physical function in these same populations. Moderate evidence indicated that for older adults who sustained a hip fracture or stroke, extended exercise programs and mobility-oriented physical activity improved physical function.
CONCLUSIONS
Regular physical activity effectively helps older adults improve or delay the loss of physical function and mobility while reducing the risk of fall-related injuries. These important public health benefits underscore the importance of physical activity among older adults, especially those living with declining physical function and chronic health conditions.
目的
审查和更新 2018 年体力活动指南咨询委员会科学报告（PAGAC 报告）中提出的社区居住老年人体力活动、跌倒相关伤害风险和身体功能之间关系的证据。
方法
从 PubMed®、Cochrane 图书馆和 CINAHL 数据库中重复独立筛选出 2006 年至 2016 年期间发表的 1415 项系统评价和荟萃分析，共筛选出 111 篇文章用于 PAGAC 报告。PAGAC 老龄化小组委员会成员根据五项标准评分表对科学证据强度进行评分，并将其分为四个等级之一：强、中、有限或无法分配。对 2017 年 1 月至 2018 年 3 月期间发表的 368 篇文章进行了更新搜索，又获得了 35 篇相关文章。
结果
强有力的证据表明，体力活动可将跌倒相关伤害的风险降低 32%至 40%，包括需要医疗护理或住院治疗的严重跌倒。强有力的证据还支持体力活动以一种反向分级的方式改善了一般老龄化人群的身体功能，并降低了与年龄相关的身体功能丧失的风险，还改善了体弱和帕金森病老年人的身体功能。有氧运动、肌肉强化和/或多组分体力活动方案在这些相同人群中最大程度地改善了身体功能。中等证据表明，对于髋部骨折或中风的老年人，延长的运动方案和以移动为导向的体力活动可改善身体功能。
结论
定期体力活动可有效帮助老年人改善或延缓身体功能和活动能力的丧失，同时降低跌倒相关伤害的风险。这些重要的公共卫生益处突显了体力活动对老年人的重要性，尤其是对那些身体功能下降和患有慢性健康状况的老年人。
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