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Device-measured physical activity, sedentary time, and risk of all-cause mortality: an individual participant data analysis of four prospective cohort studies

医学 前瞻性队列研究 人口学 体质指数 队列研究 队列 比例危险模型 代谢当量 久坐的生活习惯 体力活动 低风险 置信区间 老年学 物理疗法 内科学 社会学
作者
Edvard H. Sagelv,Laila Arnesdatter Hopstock,Bente Morseth,Bjørge Herman Hansen,Jostein Steene‐Johannessen,Jonas Johansson,Anna Nordström,Pedro F. Saint‐Maurice,Ola Løvsletten,Tom Wilsgaard,Ulf Ekelund,Jakob Tarp
出处
期刊:British Journal of Sports Medicine [BMJ]
卷期号:57 (22): 1457-1463 被引量:24
标识
DOI:10.1136/bjsports-2022-106568
摘要

Objectives To examine whether moderate-to-vigorous physical activity (MVPA) modifies the association between sedentary time and mortality and vice versa, and estimate the joint associations of MVPA and sedentary time on mortality risk. Methods This study involved individual participant data analysis of four prospective cohort studies (Norway, Sweden, USA, baseline: 2003–2016, 11 989 participants ≥50 years, 50.5% women) with hip-accelerometry-measured physical activity and sedentary time. Associations were examined using restricted cubic splines and fractional polynomials in Cox regressions adjusted for sex, education, body mass index, smoking, alcohol, study cohort, cardiovascular disease, cancer, and/or diabetes, accelerometry wear time and age. Results 6.7% (n=805) died during follow-up (median 5.2 years, IQR 4.2 years). More than 12 daily sedentary hours (reference 8 hours) was associated with mortality risk only among those accumulating <22 min of MVPA per day (HR 1.38, 95% CI 1.10 to 1.74). Higher MVPA levels were associated with lower mortality risk irrespective of sedentary time, for example, HR for 10 versus 0 daily min of MVPA was 0.85 (95% CI 0.74 to 0.96) in those accumulating <10.5 daily sedentary hours and 0.65 (95% CI 0.53 to 0.79) in those accumulating ≥10.5 daily sedentary hours. Joint association analyses confirmed that higher MVPA was superior to lower sedentary time in lowering mortality risk, for example, 10 versus 0 daily min of MVPA was associated with 28–55% lower mortality risk across the sedentary time spectrum (lowest risk, 10 daily sedentary hours: HR 0.45, 95% CI 0.31 to 0.65). Conclusions Sedentary time was associated with higher mortality risk but only in individuals accumulating less than 22 min of MVPA per day. Higher MVPA levels were associated with lower mortality risk irrespective of the amount of sedentary time.
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