A Study Of The Characteristics And Recommendations On Daily Steps For 60-70 Yr Old Adults In Urban Communities

Background:Physical inactivity is considered a major risk factor for a number of adverse health outcomes for older adults as their physiological function declining with their age,making them vulnerable groups of non-communicable chronic diseases such as cardiovascular disease,hypertension,diabetes,obesity,cancer and mental disorders.and each additional 10 years old,chronic disease prevalence rate was increased by more than 50%.These diseases not only impaired the senior citizen’s physical and mental health,and reduced quality of life,but also added health care costs of the family and the society.As a result,some government agencies and health organization based on time and intensity or steps per day to develop guidelines in health promotion activities respectively,suggesting that the elderly should undertake at least 150 minutes of moderate-to-vigorous physical activity（MVPA）per week or a target of 10000 steps per day.In the two recommendations,the former have been based on self-reported PA related to mortality and disease outcomes,but its intensity is difficult to understand and grasp,so do the combination of strength and time in application;the latter is a recommendation that is ease to understand and simple to use,but it is only a pedometer manufacturer’s nickname for their product.There has been long-standing controversy about whether the recommendations is appropriate to older adults,but little authoritative evidence has been provided.There is a significantly dosage-response relationship between step per day and health outcomes.To maintain and develop one’s health,a goal of steps per day shoud be set not only with the benefits for health,but also with its implementation and sustainability.If current public health physical activity guidelines can be translated into steps per day,it would be a useful supplement for these recommendations.Objectives:The aim of this study was to understand the quantity and characteristics of daily steps in urban community-dwelling older population,and analyze the relationship between step counts and health outcomes,and determine the optimal cut-point of steps per day for health promotion.It will provides reference for the elderly physical activity monitoring,intervention,tracking and intervention.Subjects and Methods:A urban community sample of 750 older adults aged 60-79 wore a Actigraph accelerometer combined with filling in a physical activity log for a week in 2015-2016 and completed a health assessment to collect data of height,weight,blood pressure（BP）,fasting blood glucose（GLU）,triglycerides（TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）and total cholesterol（TC）.A repeated measures analysis of variance（ANOVA）was used to determine if steps per day is different across days of the week.The intergroup mean difference was compared with the independent sample t-test.the Pearson’s correlation coefficient was used to assess the agreement between physical activity and health outcomes.The Binary Logistic regression was used to examine the association between the accelerometry-derived steps per day and a cluster of health indicators in Chinese Urban elderly.Receiver Operator Characteristic Curve（ROC）was used to determine the optimal cut-off of steps per day needed to meet current public health recommendations for MVPA.Results:（1）Average daily step-count was 7630.1±3001.2,and Only 20.6%of participants achieved the recommended 10000 steps per day put forward by China’s ministry of health in the health life style action.Step counts accumulated more in weekday（7914.5±3331.3 vs 6919.8±2648.1,t=6.068,p=0.000）and housework and at low cadences of 1-19 steps/min,while step peak hours is longer in the morning than afternoon or evening.Men taken more steps than women（7861.2±3039.4 vs 7404.3±2957.8,t=1.977,p=0.048）,and more steps were also taken by the higher ones of age than the lower ones,so did the normal weight group than overweight or obesity group（7899.9±2647.6 vs 7321.4±2573.5,t=2.872,p=0.004）,but steps per day in different ages,educational levels and household size groups had no statistically significant difference（P>0.05）.（2）The results of partial correlation analysis adjusted for age,sex,BMI and MVPA showing weak but significant negative correlations（p<0.05）between steps per day and BMI（r=-0.270）,SBP（r=-0.222）,GLU（r=-0.254）,TG（r=-0.270）ans TC（r=-0.250）,and there were moderate negative correlation between steps per day and LDL-C（r=-0.308）,positive correlation for HDL-C（r=0.253）,no significant relationship for DBP;Logistic regression analysis indicated that The abnormal rate and risk factors clustering of health outcomes is decreasing with the increase of daily steps（OR<1,P<0.05）;In addition to SBP and the cluster of health risk factors,MVPA has an impact on the relationship between daily steps and other health indicators.（3）Steps per day is positively associated with Minutes of MVPA that occurred in bouts of at least 10 continuous minutes or Minutes of intermittent MVPA（r₁=0.784,r₂=0.751,all of p<0.01）.The results suggest suggest that 7200 to 7800 steps/d and 8000 to 8700 steps/d represented the optimal thresholds for accumulating at least 150 minutes per week for elder in intermittent MVPA or continuous MVPA.The result of retesting suggested that the new steps cut-points put there has the high classification accuracy compared with the existing steps cup-point,and could effectively reflect the fact that increasing physical activity may improve health,while physical inactivity lead to poor physical quality.Conclusions:（1）Objective data indicated that accelerometer-determined steps per day of the elderly in urban community should be promoting,and lower levels of daily steps were observed in female,overweight\obesity,and during weekend days.study participants accumulate more steps at low cadence of domestic work;（2）Statistical significant associations were observed between steps per day and a number of health indicators,and the abnormal rate of health outcomes is decreasing in lower volatility with the increase of daily steps,but it is influenced by the cumulative intensity of steps.（3）7200 to 7800 steps/d and 8000 to 8700 steps/d represented the optimal thresholds for accumulating at least 150 minutes per week for elder in intermittent MVPA or continuous MVPA.