Chinese Journal of Tissue Engineering Research ›› 2025, Vol. 29 ›› Issue (17): 3566-3571.doi: 10.12307/2025.662

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

Hong Jintao1, Wang Jingjing1, Li Yansong2, Wang Chen1, Mi Shouling3, 4, 5, 6, 7   

  1. 1Shanghai Research Institute of Sports Science (Shanghai Anti-doping Agency), Shanghai 200030, China; 2School of Physical Education, Qingdao University, Qingdao 266071, Shandong Province, China; 3Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China; 4National Clinical Research Center for Interventional Medicine, Shanghai 200032, China; 5State Key Laboratory of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 6NHC Key Laboratory of Ischemic Heart Diseases, Shanghai 200032, China; 7Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai 200032, China
  • Received:2024-07-01 Accepted:2024-08-24 Online:2025-06-18 Published:2024-10-31
  • Contact: Mi Shouling, MD, Associate chief physician, 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
  • About author:Hong Jintao, MS, Assistant researcher, Shanghai Research Institute of Sports Science (Shanghai Anti-doping Agency), Shanghai 200030, China
  • Supported by:
    Shanghai Municipal Science and Technology Commission Program 2023 – “Science and Technology Innovation Action Plan,” No. 23DZ1204201 (to WC)

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Abstract: 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 predictive effect on fear of falling (β=0.164, P < 0.01), indicating that age moderates the effect of sedentary behavior on fear of falling.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: older adults, aging, muscle atrophy, muscle strength, sedentary behavior, fear of falling, mediating effect, moderating effect

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