| Objective:we adopt the methods of epidemiology and biometrics to screen the indicators suitable for the physical fitness assessment in the community elderly population aged over 60 in geriatric medicine and health care for theoretical guidance,and build a comprehensive and multidimensional physical fitness assessment scale with physical form,function and quality for elderly people and preliminarily established physical fitness prediction and assessment model for different age groups and genders.It provides an important basis and reference for assessing the intrinsic essence of the physical fitness,monitoring the physical fitness of the elderly,the improvement of the quality of life and the"healthy aging".Method:(1)We preliminary collect,screen and analyze the relevant indicators of physical fitness assessment,using the the method of literature collection and consultation.Delphi method(Delphi)to score the importance of indicators,feasibility and authority to determine the elderly constitution The three-level indicator system for evaluation.(2)Using the analytic hierarchy process(AHP)to calculate and allocate the weight of the indicator,respectively to compare two indicators at all levels in order to get relative importance score,calculate the normalized weights and the combination weights,to establish the comprehensive evaluation of physical fitness scale for the elderly.Consistency index(CI)was used to check whether the weight result of analytic hierarchy process was logical.The Cronbach’αcoefficient and retest reliability coefficient,content validity index(I-CVI),content validity index(S-CVI)and exploratory factor method were used to analyze the reliability and validity of the scale.(3)The physical fitness scale was used to preliminarily evaluate the physical fitness of the elderly people in the community,describe the distribution characteristics of the total score and the level of each dimension of the different age and gender,and to explore the comprehensive physical condition of the elderly.(4)Using 11 models,such as Linear,Logarithmic,Inverse,Quadratic,Cubic,Compound,Power,S,Growth,Exponential,Logistic and so on,to fit the individual’s physical fitness score and the age,and optimize the optimal model(curve equation)for the comprehensive assessment and prediction of the physical fitness of the elderly in the community.Result:(1)237 papers were collected and 57 indicators with 78.95%quantitative test indicators were formed to build up the indicators system of the elderly’s physical fitness.After two rounds of Delphi expert consultation,the authority degree,judgment coefficient and familiarity coefficient of the 18 experts were 0.89,0.86 and 0.88 respectively.The coefficient of importance and feasibility of the indicator was 0.306 and 0.317(p<0.001).According to index of the importance,feasibility and coefficient of variation of the standard selection,determine the three-level indicators system of 25 items(quantitative test indicators 72%):three level indicators(physical form,function,quality),7 secondary indicators(morphology,physical,cardiopulmonary function,daily life ability,strength,flexibility,balance and agility),three-level indicator 25 items habit(grip strength,comfortable gait speed,etc.).(2)The weight distribution of indicators at each level:W morphological appearance=0.122,W function=0.320 and W quality=0.558.The Cronbach’αreliability coefficient of the physical fitness scale was 0.842,and the test-retest reliability was 0.869(P<0.001).The content validity(I-CVI)of the content validity index was between 0.89 and 1.00,and the evaluation was“excellent”.The content validity(S-CVI)of the whole scale was S-CVI/UA 0.88(>0.80),and the average S-CVI was 0.988(>0.90).Structure validity was extracted by factor analysis seven common,which could explain 55.89%of the variance of the total variance,and the public degree of each index was between 0.396 and 0.836.(3)The preliminary application of the scale effectively investigate and test 971elderly people,the ratio of men and women is 0.973:1.The results show that the comprehensive physical fitness score and each dimension score show a decreasing distribution and characteristics with increasing age.The physical fitness scores of male aged 60-75 years old were higher than those of the same aged female(P<0.05),mainly in the two dimensions of function and quality(P<0.05),and the differences in morphology and physical dimension were not significant(P>0.05).(4)Fitting results of the 11 models showed that all models had significant significance(P<0.01),and both Quadratic and Cubic models with the highest coefficient of determination(R~2),R~2male=0.776,R~2female=0.845.Therefore,the Quadradic model was chosen to fit the physical fitness and age of male and female individuals.The curve equation is:(?)_男(28)330.040-6.096x(10)0.032x~2(?)_女(28)180.524-2.155x(10).0006x~2 It can make a comprehensive evaluation of the physical status of individuals of different genders and ages.Conclusion:(1)Refine and identify 25 physiological indicators related to the physical fitness of the elderly(including the three dimensions of morphology,function,and quality),and the selected indicators are better represented by the series of statistical analysis,and the degree of acceptance is higher.The constructed scale structure has high reliability and validity and can provide scientific basis for assessing the physical status of the elderly.(2)The scale’s evaluation of the physical fitness of the elderly shows that as the age increases,the physical fitness score and the scores of all dimensions show a downward trend,which reflects the effect of aging on physical fitness;The physical score of the aged 60～75 years old was higher than that of the same age female,which was mainly manifested in the two dimensions of function and quality,and the difference in morphology dimension was not obvious.(3)The proposed comprehensive physical fitness indicator system and scale for senior are representative,accurate,and objective,and can reflect the three dimensions of the morphology,function,and quality of the elderly.It is easy to understand,simple,fast,safe and economical and easy to accept.It is suitable for the physical fitness assessment of the elderly people in the community.(4)According to the individual scores of the scale and the Quadratic model,it can be intuitively drawn that the level of the physical level of a certain individual at the same age,and the primary state of the physical state of the elderly can be judged,so that it is convenient for the comprehensive assessment and follow-up monitoring of the individuals over 60 years old in the community. |
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