目的:探讨中老年人体力活动轨迹与其工具性日常生活自理能力(instrumental activities of daily living,IADL)的关系.方法:基于2011-2018年中国健康与养老追踪调查(the China health and retirement longitudinal study,CHARLS)的全国代表性大规模追踪数据,采用组基轨迹模型识别调查对象随访期间体力活动随时间变化的潜在分组和轨迹特征;采用多因素logistic回归模型分析不同体力活动轨迹类型与IADL失能的关联性.结果:调查对象体力活动轨迹被分为持续低体力活动组(2 703人,占66.89%)、体力活动降低组(641人,占15.86%)、体力活动增加组(375人,占9.28%)及持续高体力活动组(322 人,占7.97%),4组间IADL失能发生率比较,差异具有统计学意义(χ2=19.46,p<0.001).多因素logistic回归模型显示,与持续低体力活动组比较,体力活动增加组和持续高体力活动组发生IADL失能的风险降低,对应的比值比(95%可信区间)分别为0.73(0.55,0.97)和0.59(0.42,0.83).按性别、年龄、居住地和慢性病进行亚组分析结果显示,男女持续高体力活动组发生IADL失能的风险明显降低,而这种显著的关联性仅出现在60岁及以上老年人、居住在农村者和无慢性病者中.结论:不同类型体力活动轨迹与日常生活自理能力相关,持续高体力活动与体力活动增加轨迹会降低工具性日常生活自理能力失能的风险.
Association of Physical Activity Trajectory with Instrumental Activities of Daily Living among Middle-aged and Older Adults
Objective:To explore the relationship between physical activity trajectory and instrumental activities of daily living(IADL)among middle and older adults.Methods Based on a nationally representative large-scale survey of the China health and retirement longitudinal study(CHARLS)project during 2011-2018,the group-based trajectory model(GBTM)was used to identify the potential trajectory characteristics of physical activity over time during the follow-up period.Multivariate logistic regression model was fitted to analyze the correlation between different physical activity trajectory and IADL disability.Results:The physical activity trajectory was divided into four groups:consistently low physical activity group(2703 subjects,66.89%),reduced physical activity group(641 subjects,15.86%),increased physical activity group(375 subjects,9.28%),and consistently high physical activity group(322 subjects,7.97%).There was significant difference in the incidence of IADL disability among the four groups(χ2=19.456,p<0.001).Multivariate logistic regression model showed that compared with the consistently low physical activity group,the increased physical activity group and the consistently high physical activity group had a reduced risk of IADL disability,corresponding to odds ratios(95%confidence intervals)of 0.73(0.55,0.97)and 0.59(0.42,0.83),respectively.Subgroup analyses by sex,age,residence,and chronic disease showed that the risk of IADL disability was significantly reduced in men and women with persistently high physical activity,and this significant association was only observed among older people≥60 years,those living in rural areas,and those without chronic disease.Conclusion:Different patterns of physical activity trajectories are correlated with IADL disability.Consistently high physical activity and increased physical activity trajectories reduce the risk of IADL disability.
Physical activityGroup-based trajectoryInstrumental activities of daily living
NETL
NSTL
万方数据
维普
