Physical activity (PA) and sedentary behavior (SB) are not stable conditions but change over time and among individuals, and both could have deleterious effects on health-related outcomes among older adults. This study aimed to identify the longitudinal trajectories of PA and SB and estimate their association with quality of life, disability, and all-cause mortality in a national sample of older Mexican adults. Data comes from three waves of the WHO Study on global AGEing and adult health (SAGE) in Mexico (2009, 2014, 2017). In total, 3209 older adults ages 50 and above were included. PA and SB were determined by using the Global Physical Activity Questionnaire (GPAQ). Disability was measured using the WHO Disability Assessment Schedule (WHODAS 2.0), quality of life using the WHOQOL (WHO Quality of Life) instrument, and all-cause mortality using a verbal autopsy. We used growth mixture modeling (GMM) to investigate the longitudinal trajectories of PA and SB. Three-level linear mixed effect models were used to estimate the associations of PA and SB with quality of life and disability and the Cox model for the association with all-cause mortality. Three longitudinal trajectories of PA and SB were found: low-PA-decreasers, moderate-PA-decreasers, and high-PA-decreasers for PA; and low-maintainers, steep-decreasers, and steep-increasers for SB. Decreased quality of life, increased disability, and all-cause mortality were all consistently associated with worse PA and SB trajectories. Our results highlight the need for health policies and prevention strategies that promote PA and limit SB in middle-aged adults. Further studies should consider these activities/behaviors as exposures that vary throughout life and work to identify vulnerable groups of older adults for whom physical activation interventions and programs would be most impactful.

中文翻译：

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体力活动和久坐行为轨迹及其与生活质量、残疾和全因死亡率的关联


身体活动（PA）和久坐行为（SB）并不是稳定的条件，而是会随着时间的推移和个体之间的变化而变化，两者都可能对老年人的健康相关结果产生有害影响。本研究旨在确定 PA 和 SB 的纵向轨迹，并评估它们与墨西哥全国老年人样本的生活质量、残疾和全因死亡率的关系。数据来自世界卫生组织在墨西哥进行的三轮全球老龄化和成人健康研究（SAGE）（2009年、2014年、2017年）。总共包括 3209 名 50 岁及以上的老年人。 PA 和 SB 通过全球身体活动问卷 (GPAQ) 确定。使用世界卫生组织残疾评估表（WHODAS 2.0）来衡量残疾情况，使用世界卫生组织生活质量（WHOQOL）工具来衡量生活质量，并使用口头尸检来衡量全因死亡率。我们使用生长混合模型（GMM）来研究 PA 和 SB 的纵向轨迹。三水平线性混合效应模型用于估计 PA 和 SB 与生活质量和残疾的关联，以及 Cox 模型用于估计与全因死亡率的关联。发现PA和SB的三个纵向轨迹：PA的低PA减少器、中PA减少器和高PA减少器； SB 的低维持者、急剧减少者和急剧增加者。生活质量下降、残疾增加和全因死亡率均与较差的 PA 和 SB 轨迹相关。我们的结果强调需要制定促进中年成人 PA 和限制 SB 的健康政策和预防策略。 进一步的研究应将这些活动/行为视为在一生中变化的暴露，并努力确定身体激活干预措施和计划对他们最有影响力的老年人弱势群体。