Dataset Information

Examining the independent and interactive association of physical activity and sedentary behaviour with frailty in Chinese community-dwelling older adults.

ABSTRACT:

Background

While physical inactivity or prolonged sitting has been linked to an increased risk of frailty, the interaction between sitting time (ST), physical activity (PA) and frailty is not well understood. The aim of this study was to examine the dose-response relationship between PA, ST and frailty and further to evaluate the interaction effect of PA and ST on frailty in the context of regular COVID-19 epidemic prevention and control in China.

Methods

A cross-sectional analysis was performed on 1458 participants (age ≥ 60) enrolled from a prospective cohort study of frailty in elderly people of Fujian Province. PA and ST levels were assessed using the International Physical Activity Questionnaire. A 40-item frailty index (FI) quantified frailty. Multivariable logistic regression and linear regression models were applied to examine the dose-response relationship between PA or ST and frailty level. Interaction plots were used to visualise the interaction effects of PA and ST on frailty.

Results

Compared with light PA, the odds ratios (ORs) for frailty were significantly lower for moderate PA (OR, 0.609 [95% CI, 0.419, 0.885], P < .001) and vigorous PA (OR, 0.399 [95% CI, 0.236,0.673], P < .001). Comparing subjects with ST < 4 h/day, those with ST ≥ 8 h/day were significantly more likely to be diagnosed with frailty (OR, 3.140 [95% CI, 1.932, 5.106], P < .001), 6-8 h/day (OR, 1.289 [95% CI, 0.835, 1.989], P >0.05), and 4-6 h/day (OR, 1.400 [95% CI, 0.972, 2.018], P >0.05). Each one unit increase in metabolic equivalents (h/day) of PA was related to an average 0.928 (0.887, 0.971) decrease in prevalence of frailty, while each one unit increase in sitting time (h/day) was related to average 1.114 (1.046,1.185) increase in prevalence of frailty. Negative interactive effects of PA and ST on frailty were observed (P < 0.001).

Conclusion

There are nonlinear and linear dose-response relationships between PA, SB and frailty respectively. In addition, excess ST may counteract the beneficial effects of PA on frailty. Interventions that focus on reducing excess ST may be effective strategies to reduce the risk of frailty and should be taken seriously by public health authorities, especially in the context of regular epidemic prevention and control in China.

SUBMITTER: Li N

PROVIDER: S-EPMC9313602 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundOlder adults are recommended to sleep 7-8 h/day. Time in bed (TIB) differs from sleep duration and includes also the time of lying in bed without sleeping. Long TIB (≥9 h) are associated with self-reported sedentary behavior, but the association between objectively measured physical activity, sedentary behavior and TIB is unknown.MethodsThis study was based on cross-sectional analysis of the Healthy Ageing Network of Competence (HANC Study). Physical activity and sedentary behaviour were measured by a tri-axial accelerometer (ActiGraph) placed on the dominant wrist for 7 days. Sedentary behavior was classified as < 2303 counts per minute (cpm) in vector magnitude and physical activity intensities were categorized, as 2303-4999 and ≥ 5000 cpm in vector magnitude. TIB was recorded in self-reported diaries. Participants were categorized as UTIB (usually having TIB 7-9 h/night: ≥80% of measurement days), STIB (sometimes having TIB 7-9 h/night: 20-79% of measurement days), and RTIB (rarely having TIB 7-9 h/night: < 20% of measurement days). Multinominal regression models were used to calculate the relative risk ratios (RRR) of being RTIB and STIB by daily levels of physical activity and SB, with UTIB as the reference group. The models were adjusted for age, sex, average daily nap length and physical function.ResultsThree hundred and fourty-one older adults (median age 81 (IQR 5), 62% women) were included with median TIB of 8 h 21 min (1 h 10 min)/day, physical activity level of 2054 (864) CPM with 64 (15) % of waking hours in sedentary behavior. Those with average CPM within the highest tertile had a lower RRR (0.33 (0.15-0.71), p = 0.005) for being RTIB compared to those within the lowest tertile of average CPM. Accumulating physical activity in intensities 2303-4999 and ≥ 5000 cpm/day did not affect the RRR of being RTIB. RRR of being RTIB among highly sedentary participants (≥10 h/day of sedentary behavior) more than tripled compared to those who were less sedentary (3.21 (1.50-6.88), p = 0.003).ConclusionsFor older adults, being physically active and less sedentary was associated with being in bed for 7-9 h/night for most nights (≥80%). Future longitudinal studies are warranted to explore the causal relationship sbetween physical activity and sleep duration.