노인의 노쇠, 신체활동과 일상생활체력의 관련성
Frailty, Physical Activity and Functional Fitness in the Community-dwelling Elderly
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초록
노쇠는 노인의 낙상, 장애, 요양시설입소, 사망 등과 밀접한 관련이 있으며, 체력저하는 노쇠의 주요 기여 인자이다. 본 연구의 목적은 65세 이상 노인을 대상으로 노쇠, 신체활동, 일상생활체력의 관련성을 분석하는데 있다. 본 연구는 2015년(2차년도) ‘국민체력100 한국인 건강체력 기준개발’ 사업에 참여한 65세 이상 여성노인(338명, 70.6±4.2세)을 대상으로 하였다. 노인의 노쇠 분류는 Fried 기준을 이용하였으며, 신체활동은 국제신체활동설문지(IPAQ)를 사용하여 WHO의 신체활동 권장량을 기준으로 신체활동 실천 유무를 구분하였다. 일상생활체력은 국민체력100 노인기 체력항목을 사용하였으며, 삶의 질은 건강상태 점수(EQ-VAS)와 WHO 삶의 질(WHOQOL)을 사용하였다. 연구결과, 전노쇠노인은 건강노인보다 연령과 비만관련 요인(체질량지수, 체지방률, 허리둘레)이 유의하게 높았다. 전노쇠노인은 연령과 체지방률을 보정한 후에도 건강노인보다 걷기, 중강도 그리고 총 신체활동량이 유의하게 낮았으나, 고강도 활동에서는 유의한 차이가 나타나지 않았다. 또한 전노쇠노인은 건강노인에 비해 모든 일상생활체력과 삶의 질이 유의하게 낮았다. 노쇠상태 및 신체활동 유무에 따른 일상생활체력 비교 결과, 전노쇠하면서 신체활동을 비실천하는 노인은 건강하면서 신체활동을 실천하는 노인 보다 모든 일상생활체력이 유의하게 낮았다. 근지구력과 협응력은 신체활동 실천과 관련이 있었는데 이는 전노쇠와 건강노인 모두에 해당한다. 그리고 심폐지구력은 전노쇠하면서 신체활동을 실천하는 노인이 전노쇠하면서 신체활동을 비실천하는 노인 보다 높았다. 이상의 결과를 종합하면, 신체활동은 전노쇠노인과 건강노인의 일상생활체력와 정적 연관성이 있었다. 전노쇠노인의 신체활동은 체력유지에 도움이 될 것이다.
Abstract
The frailty, characterized by reduced physiological function is closely related to a fall, disability, institutionalization, hospitalization, and mortality in the elderly. A reduced physical fitness is a major phenotype of the frailty. The purpose of this study was to investigate the relationship among pre-frailty, physical activity (PA) and functional fitness in the community dwelling elderly women. The study participants were elderly women (n=338, 70.6±4.2years) aged over 65 who took part in the Korean Healthy Fitness Criteria study for the National Fitness Award Project in 2015. The pre-frailty was defined using the Cardiovascular Health Study frailty criteria. PA was assessed using the International PA Questionnaire (IPAQ). The participants were classified as regular PA participants if they meet the World Health Organization (WHO) PA recommendation for the elderly. Functional fitness was assessed using the composite of the National Fitness Award fitness testing for the elderly. Quality of life was evaluated using EuroQoL visual analogue scale and WHO quality of life assessment. As the results, the pre-frail elderly women were significantly older and obese (body mass index, percent body fat, waist circumference) than the healthy elderly. The pre-frail elderly presented significant decreases in walking, moderate intensity, and total PA compared to the healthy elderly even after adjusted for age and percent body fat. However, no significant difference was found in vigorous-intensity activity between the pre-frail and healthy elderly. Also, the pre-frail elderly women showed the decrease in functional fitness and quality of life compared to the healthy elderly. Regular PA was associated with high levels of muscular endurance and coordination in healthy and pre-frail elderly. In pre-frail elderly, high levels of cardiorespiratory endurance was associated with PA. In conclusion, regular PA is inversely associated with fitness decline in healthy and pre-frail community-dwelling elderly women. Regular PA might attenuate fitness decline in pre-frail elderly women.
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