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体力活动与老年澳大利亚女性伤害性跌倒:澳大利亚女性健康纵向研究中身体功能限制和衰弱的调整关联和修饰。

Physical activity and injurious falls in older Australian women: adjusted associations and modification by physical function limitation and frailty in the Australian Longitudinal Study on Women's Health.

机构信息

Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.

School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia.

出版信息

Age Ageing. 2023 Jun 1;52(6). doi: 10.1093/ageing/afad108.

Abstract

OBJECTIVES

To investigate associations between leisure-time physical activity (LPA) and injurious falls in older women and explore modification of associations by physical function and frailty.

METHODS

Women born during 1946-51 from the Australian Longitudinal Study on Women's Health, injurious falls (self-reported fall with injury and/or medical attention) and self-reported weekly LPA (duration and type). We undertook cross-sectional and prospective analyses using data from 2016 [n = 8,171, mean (SD) age 68 (1)] and 2019 surveys (n = 7,057). Associations were quantified using directed acyclic graph-informed logistic regression and effect modification examined using product terms.

RESULTS

Participation in LPA as recommended by World Health Organization (150-300 min/week) was associated with lower odds of injurious falls in cross-sectional (adjusted Odds Ratio (OR) 0.74, 95% CI 0.61-0.90) and prospective analyses (OR 0.75, 95% CI 0.60-0.94). Compared with those who reported no LPA, cross-sectionally, odds of injurious falls were lower in those who reported brisk walking (OR 0.77, 95% CI 0.67-0.89) and vigorous LPA (OR 0.86, 95% CI 0.75-1.00). No significant association was found between different types of LPA and injurious falls prospectively. Only cross-sectionally, physical function limitation and frailty modified the association between LPA and injurious falls, with tendencies for more injurious falls with more activity in those with physical limitation or frailty, and fewer injurious falls with more activity among those without physical function limitation or frailty.

CONCLUSION

Participation in recommended levels of LPA was associated with lower odds of injurious falls. Caution is required when promoting general physical activity among people with physical limitation or frailty.

摘要

目的

调查老年女性休闲时间体力活动(LPA)与受伤性跌倒之间的关联,并探讨身体功能和虚弱对此关联的修饰作用。

方法

来自澳大利亚女性健康纵向研究的参与者为 1946-1951 年出生的女性,研究对象包括受伤性跌倒(自我报告的跌倒致伤和/或就医)和自我报告的每周 LPA(时长和类型)。我们使用 2016 年(n=8171,平均年龄 68(1)岁)和 2019 年调查的数据进行了横断面和前瞻性分析。使用有向无环图(DAG)信息逻辑回归来量化关联,并使用乘积项来检验效应修饰作用。

结果

按照世界卫生组织(WHO)建议(每周 150-300 分钟)进行 LPA 与横断面(调整后的比值比(OR)0.74,95%置信区间(CI)0.61-0.90)和前瞻性分析(OR 0.75,95% CI 0.60-0.94)中受伤性跌倒的可能性降低相关。与没有报告 LPA 的人相比,报告快步走(OR 0.77,95% CI 0.67-0.89)和剧烈 LPA(OR 0.86,95% CI 0.75-1.00)的人受伤性跌倒的可能性更低。在前瞻性分析中,不同类型的 LPA 与受伤性跌倒之间未发现显著关联。仅在横断面研究中,身体功能受限和虚弱状态修饰了 LPA 与受伤性跌倒之间的关联,身体功能受限或虚弱的个体中,活动量增加与受伤性跌倒的可能性增加有关,而身体功能正常或不虚弱的个体中,活动量增加与受伤性跌倒的可能性减少有关。

结论

参加推荐水平的 LPA 与受伤性跌倒的可能性降低相关。在身体功能受限或虚弱的人群中推广一般性体力活动时需要谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a5a/10312133/cc9876898b18/afad108f1.jpg

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