知识与财富的链接
分析我国老年人身体活动对衰弱的影响,探讨体重调整腰围指数在其作用路径上发挥的中介效应,为制定有效的衰弱干预策略提供科学依据。 将2013年中国健康与养老追踪调查数据作为基线,收集基线调查时无衰弱者,追踪随访2020年衰弱发生情况,采用衰弱指数评估我国老年人的衰弱状况。采用二元logistic回归分析模型和限制性立方样条分析身体活动、体重调整腰围指数对衰弱的影响,并建立中介效应模型。 经过近7年随访,1 983名老年人中有936人发生衰弱,衰弱率为47.2%。多因素logistic回归分析模型结果显示：体重调整腰围指数≥11.25增加老年人衰弱发生风险(OR=1.232, 95% CI: 1.004~1.514, P=0.046);高身体活动降低老年人衰弱发生风险(OR=0.690, 95% CI: 0.566~0.842, P＜0.001)。随着体重调整腰围指数增加,衰弱风险呈上升趋势。随着每周体力活动水平的提高,衰弱风险逐渐下降后略有上升,最低值出现在3 800 MET/周。体重调整腰围指数在老年人身体活动与衰弱之间发挥部分中介作用,效应值为-0.012(95% CI: -0.020~-0.006, P＜0.001),占总效应的13.5%。 低身体活动水平和高体重调整腰围指数使老年人的衰弱风险增加,维持适度的身体活动(3 800 MET/周)并开展科学的体重管理,有助于降低衰弱的发生风险并延缓其进程。
Objective Analyze the impact of physical activity on frailty among elderly people in China, explore the mediating effect of weight adjusted waist circumference index on its pathway of action, and provide a scientific basis for formulating effective frailty intervention strategies. Methods Using the 2013 data from the China Health and Retirement Longitudinal Study (CHARLS) as the baseline, we collected data from individuals who did not experience frailty at the time of the baseline survey, and followed up on frailty occurrences until 2020. We evaluated the frailty status of elderly people in China using the frailty index. And binary logistic regression model and restricted cubic spline method were used to analyze the effects of physical activity and weight adjusted waist circumference index on frailty. Furthermore, we established a mediation effect model. Results After nearly 7 years of follow-up, 936 out of 1 983 elderly people experienced frailty, with a frailty rate of 47.2%. The multiple logistic regression analysis showed that the waist circumference index ≥11.25 after weight adjustment increased the risk of frailty in the elderly (OR=1.232, 95% CI: 1.004-1.514, P=0.046), while physical activity reduced the risk of frailty in the elderly (OR=0.690, 95% CI: 0.566-0.842, P < 0.001). As weight adjusted waist circumference index increased, the risk of frailty increased. As the weekly physical activity level increased, the risk of frailty gradually decreased and then slightly increased, with the lowest value appearing at 3 800 MET/week. The weight adjusted waist circumference index played a partial mediating role between physical activity and frailty in the elderly, with an effect value of -0.012 (95% CI: -0.020--0.006, P < 0.001), accounting for 13.5% of the total effect. Conclusions Low levels of physical activity and weight adjusted waist circumference index increase the risk of frailty in older adults. Maintaining moderate physical activity (3 800 MET/week) and implementing scientific weight management can help reduce the risk of frailty and delay its progression.
