The influence of physical activity on the degenerative changes in muscle strength of the upper and lower limbs in elderly individuals
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摘要:
目的 探索自然人群中老年人身体活动对上下肢肌力退行性变化的作用。 方法 基于中国健康与养老追踪调查(China health and retirement longitudinal study, CHARLS) 2015年数据集，使用握力、坐立试验、国际身体活动量表(international physical activity questionnaire, IPAQ)测量老年人的上肢肌力、下肢肌力、身体活动水平，并采用多重线性回归分析探索身体活动水平对老年人上下肢肌力退行性变化的中介作用/调节作用。 结果 本研究纳入≥60岁老年人2 808人，男性1 446人(51.50%)，女性1 362人(48.50%)。低水平身体活动者658人(23.43%)。身体活动可以减弱年龄对上下肢肌力的退行性变化的影响，发挥部分中介作用，中介效应占比分别为4.55%(95% CI: 2.31%~7.00%, P ＜ 0.001)、6.90%(95% CI: 4.48%~10.00%, P ＜ 0.001)。身体活动在上肢肌力退行性变化中未发挥调节作用(年龄×身体活动水平：β=0.421, P＞0.05)，但在下肢肌力退行性变化中发挥着调节作用(年龄×身体活动水平：β=-0.375, P ＜ 0.01)。 结论 身体活动部分介导年龄所造成的上下肢肌力退行性变化，高水平身体活动可缓解下肢肌力退行性变化程度。 Abstract:Objective This study seeks to investigate the impact of physical activity on degenerative changes in the upper and lower limbs of older adults. Methods Based on the China health and retirement longitudinal study (CHARLS) 2015 dataset. The upper and lower limb muscle strength and physical activity were measured in older adults with grip strength, sit-to-stand test, and international physical activity questionnaire (IPAQ). The multivariate linear regression analyses are used to explore the mediating and moderating effects of physical activity on degenerative changes in muscle strength. Results A total of 2 808 individuals aged 60 years and above were included in this study, 1 446 (51.50%) were males and 1 362 (48.50%) were females. A total of 658 individuals (23.43%) were identified as having insufficient physical activity. Physical activity attenuated the degenerative changes in upper and lower limb muscle strength, playing a partially mediating role, with mediating effects accounting for 4.55% (95% CI: 2.31%-7.00%, P＜0.001), and 6.90% (95% CI: 4.48%-10.00%, P ＜ 0.001) of the effect, respectively. Physical activity failed to moderate degenerative changes in upper limb muscle strength (age×physical activity: β=0.421, P > 0.05) but moderated degenerative changes in lower limb muscle strength (age×physical activity: β=-0.375, P ＜ 0.01). Conclusions Physical activity partially mediates age-induced degenerative changes in upper and lower limb muscle strength and high levels of physical activity mitigate the process of degenerative changes in lower limb muscle strength. -
Key words:
- Elderly people /
- Physical activity /
- Muscle strength /
- Mediating effect /
- Moderating effect
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表 1 老年人一般人口学特征
Table 1. Demographic characteristics of the elderly in general
变量Variable 结果Result① 变量Variable 结果Result① 年龄组/岁Age group/years 性别Gender 60~＜70 1 883(67.06) 男性Male 1 446(51.50) 70~＜80 763(27.17) 女性Female 1 362(48.50) ≥80 162(5.77) 慢性病Chronic diseases 教育程度Educational level 无No 478(17.02) 初中及以下Education level below junior high school 2 624(93.45) 1~2 1 311(46.69) 高中/职校Senior high school/vocational education 144(5.13) ≥3 1 019(36.29) 大专及以上Junior college or above 40(1.42) BMI/(kg·m-2) 婚姻状态Marital status 低体重Underweight 217(7.73) 在婚状态Married 2309(82.23) 正常Normal 1 440(51.28) 非在婚状态Non-married 499(17.77) 超重Overweight 863(30.73) 居住地Living region 肥胖Obesity 288(10.26) 城市Urban community 974(34.69) 身体活动水平Physical activity level 农村Rural village 1 834(65.31) 低水平Low level 658(23.43) 坐立试验/s Sit-to-stand test/s 10.04±3.21 中水平Medium level 827(29.45) 握力/kg Grip/kg 28.46±9.14 高水平High level 1 323(47.12) 注：①以人数(占比/%)或x±s表示。
Note: ①Number of people (proportion/%) or x±s.
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表 2 年龄、身体活动水平、上下肢肌力的相关性分析
Table 2. Correlation analysis of age, physical activity level, and upper and lower extremity muscle strength
变量
Variable年龄/岁
Age/years身体活动水平
Physical activity level握力/kg
Grip/kg坐立试验/s
Sit-to-stand test/s年龄/岁Age/years 1.00 身体活动水平Physical activity level -0.17① 1.00 握力/kg Grip/kg -0.20① 0.12① 1.00 坐立试验/s Sit-to-stand test/s 0.24① -0.15① -0.31① 1.00 注：① P ＜ 0.001。
Note: ① P ＜ 0.001.
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表 3 身体活动水平、年龄、上肢肌力多重线性回归分析
Table 3. Results of multivariate linear regression analysis between physical activity level, age, and upper limb muscle strength
自变量Independent variable 因变量Dependent variable 握力① Grip① 身体活动水平③ Physical activity level③ 握力④Grip④ β(sx) t值value β(sx) t值value β(sx) t值value 年龄/岁Age/years -3.411(0.218)② -15.606 -0.232(0.026)② -8.883 -3.256(0.221)② -14.733 身体活动水平Physical activity level 0.669(0.157)② 4.246 注：①年龄对握力的总效应；② P ＜ 0.001；③年龄对身体活动水平的效应；④控制身体活动水平后，年龄对握力的直接效应；控制年龄后，身体活动水平对握力的效应。
Note: ① The total effect of age on sit-to-stand test performance; ② P ＜ 0.001; ③ The effect of age on physical activity level; ④ The direct effect of age on sit-to-stand test performance after controlling for physical activity level; and the effect of physical activity level on sit-to-stand test performance after controlling for age.
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表 4 身体活动水平、年龄、下肢肌力多重线性回归分析结果
Table 4. Results of multivariate linear regression analysis between physical activity level, age, and lower limb muscle strength
自变量
Independent variable因变量Dependent variable 坐立试验/s①
Sit-to-stand test/s①身体活动水平③
Physical activity level③坐立试验/s④
Sit-to-stand test/s④β(sx) t值value β(sx) t值value β(sx) t值value 年龄/岁Age/years 1.498(0.098)② 15.203 -0.232(0.026)② -8.883 1.393(0.099)② 14.039 身体活动水平Physical activity level -0.453(0.070)② -6.397 注：①年龄对坐立试验表现的总效应；② P ＜ 0.001；③年龄对身体活动水平的效应；④控制身体活动水平后，年龄对坐立试验表现的直接效应；控制年龄后，身体活动水平对坐立试验表现的效应。
Note: ① The total effect of age on sit-to-stand test performance; ② P ＜ 0.001; ③ The effect of age on physical activity level; ④ The direct effect of age on sit-to-stand test performance after controlling for physical activity level; and the effect of physical activity level on sit-to-stand test performance after controlling for age.
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表 5 身体活动对上下肢肌力的调节作用分析
Table 5. Analysis of the regulatory effect of physical activity on upper and lower limb muscle strength
因变量Dependent variable 自变量Independent variable β(sx) t值value 握力/kg Grip/kg 年龄/岁Age/years -3.698(0.351)① -10.533 身体活动水平Physical activity level 0.507(0.187)② 2.721 年龄/岁×身体活动水平Age/years×physical activity level 0.421(0.260) 1.620 坐立试验/s Sit-to-stand test/s 年龄/岁Age/years 1.787(0.157)① 11.350 身体活动水平Physical activity level -0.309(0.084)① -3.690 年龄/岁×身体活动水平Age/years×physical activity level -0.375(0.116)② -3.218 注：① P ＜ 0.001; ② P ＜ 0.01。
Note: ① P ＜ 0.001; ② P ＜ 0.01.
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