久坐与社区老年人下肢肌力:跌倒恐惧与年龄的中介和调节作用  

Sedentary behavior and lower-limb muscle strength in community-dwelling older adults:the mediating and moderating effects of fear of falling and age

作　　者：洪金涛 王晶晶[1] 李岩松 王晨[1] 弭守玲 Hong Jintao;Wang Jingjing;Li Yansong;Wang Chen;Mi Shouling(Shanghai Research Institute of Sports Science(Shanghai Anti-doping Agency),Shanghai 200030,China;School of Physical Education,Qingdao University,Qingdao 266071,Shandong Province,China;Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai Institute of Cardiovascular Diseases,Shanghai 200032,China;National Clinical Research Center for Interventional Medicine,Shanghai 200032,China;State Key Laboratory of Cardiovascular Diseases,Zhongshan Hospital,Fudan University,Shanghai 200032,China;NHC Key Laboratory of Ischemic Heart Diseases,Shanghai 200032,China;Key Laboratory of Viral Heart Diseases,Chinese Academy of Medical Sciences,Shanghai 200032,China)

机构地区：[1]上海体育科学研究所(上海市反兴奋剂中心),上海市200030 [2]青岛大学体育学院,山东省青岛市266071 [3]复旦大学附属中山医院心内科,上海市心血管病研究所,上海市200032 [4]国家放射与治疗临床医学研究中心,上海市200032 [5]心脏病全国重点实验室,上海市200032 [6]国家卫生健康委缺血性心脏病重点实验室,上海市200032 [7]中国医学科学院病毒性心脏病重点实验室,上海市200032

出　　处：《中国组织工程研究》2025年第17期3566-3571,共6页Chinese Journal of Tissue Engineering Research

基　　金：上海市2023年度“科技创新行动计划”社会发展科技攻关项目(23DZ1204201),项目负责人:王晨。

摘　　要：背景:人体老龄化进程中,下肢肌肉力量会随着年龄的增长呈现显著的生理性下降,久坐、跌倒恐惧、年龄与下肢肌力之间可能存在一定关联,但它们之间的影响路径与效应关系尚不明确。目的:探究社区老年人久坐和下肢肌肉力量之间的关系,并探讨跌倒恐惧和年龄在上述两者关系中的作用。方法:共招募331名60岁及以上的上海市社区老年人。采用问卷调查法收集基本信息、人口学资料等;采用国际身体活动问卷-短卷评估久坐时间,采用30 s坐站测试测量下肢肌力,采用中文版国际跌倒效能量表测评跌倒恐惧。对数据进行描述统计、相关分析、基于回归的路径分析和中介效应检验。结果与结论:最终以318名老年人[78.9%为女性,平均年龄(67.8±5.5)岁]的有效数据纳入分析,其中久坐时间≥3 h的185名,<3 h的133名。①久坐和跌倒恐惧呈正相关关系(P<0.01),下肢肌力和久坐(P<0.01)、跌倒恐惧(P<0.001)均呈负相关关系。②久坐显著负向预测下肢肌力(β=-0.125,P<0.05),久坐显著正向预测跌倒恐惧(β=0.182,P<0.01);跌倒恐惧显著负向预测下肢肌力(β=-0.293,P<0.001)。③跌倒恐惧在久坐和下肢肌力之间起中介作用(β=-0.053,95%CI:-0.100至-0.018)。④久坐对跌倒恐惧的预测效应具有统计学意义(β=0.164,P<0.01),这说明年龄调节了久坐对跌倒恐惧的影响。BACKGROUND:The lower-limb muscle strength shows a significant physiological decline with aging.There may be a certain correlation between sedentary behavior,fear of falling,age and lower-limb muscle strength,but the influence path and effect relationship among them are not yet clear.OBJECTIVE:To examine the relationship between sedentary behavior and lower-limb muscle strength,and to explore the influences of fear of falling and age in such an association among community-dwelling older adults.METHODS:This cross-sectional study recruited 331 community-dwelling older adults(aged≥60 years)in Shanghai.A questionnaire survey was conducted to collect basic information,demographic data,etc.The Short Form of the International Physical Activity Questionnaire was applied to measure sedentary time.Lower-limb muscle strength was assessed by the 30-second chair-stand test.Fear of falling was measured by the Chinese version of Fall Efficacy Scale-International.Descriptive statistics analysis,correlation analysis,regression-based path analysis and mediation analyses were performed on the data.RESULTS AND CONCLUSION:Valid data from 318 community-dwelling older adults[78.9%females,mean age(67.8±5.5)years old]were finally included in the analysis.There were 185 with sedentary time≥3 hours and 133 with sedentary time<3 hours.(1)There was a positive correlation between sedentary behavior and fear of falling(P<0.01),and there were negative correlations between lower-limb muscle strength and sedentary behavior(P<0.01)and between lower-limb muscle strength and fear of falling(P<0.001).(2)Sedentary behavior negatively predicted lower-limb muscle strength(β=−0.125,P<0.05),and positively predicted fear of falling(β=0.182,P<0.01).Fear of falling negatively predicted lower-limb muscle strength(β=−0.293,P<0.001).(3)Fear of falling mediated the relationship between sedentary behavior and lower-limb muscle strength(β=−0.053,95%confidence interval:−0.100 to−0.018).(4)Sedentary behavior had a statistically significant predicti

关 键 词：老年群体 老龄化 肌肉萎缩 肌肉力量 久坐 跌倒恐惧 中介效应 调节作用 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R161.7