Objectively Measured Walking Duration and Sedentary Behaviour and Four-Year Mortality in Older People - PubMed (original) (raw)

Objectively Measured Walking Duration and Sedentary Behaviour and Four-Year Mortality in Older People

Jochen Klenk et al. PLoS One. 2016.

Abstract

Background: Physical activity is an important component of health. Recommendations based on sensor measurements are sparse in older people. The aim of this study was to analyse the effect of objectively measured walking and sedentary duration on four-year mortality in community-dwelling older people.

Methods: Between March 2009 and April 2010, physical activity of 1271 participants (≥65 years, 56.4% men) from Southern Germany was measured over one week using a thigh-worn uni-axial accelerometer (activPAL; PAL Technologies, Glasgow, Scotland). Mortality was assessed during a four-year follow-up. Cox-proportional-hazards models were used to estimate the associations between walking (including low to high intensity) and sedentary duration with mortality. Models were adjusted for age and sex, additional epidemiological variables, and selected biomarkers.

Results: An inverse relationship between walking duration and mortality with a minimum risk for the 3rd quartile (102.2 to128.4 minutes walking daily) was found even after multivariate adjustment with HRs for quartiles 2 to 4 compared to quartile 1 of 0.45 (95%-CI: 0.26; 0.76), 0.18 (95%-CI: 0.08; 0.41), 0.39 (95%-CI: 0.19; 0.78), respectively. For sedentary duration an age- and sex-adjusted increased mortality risk was observed for the 4th quartile (daily sedentary duration ≥1137.2 min.) (HR 2.05, 95%-CI: 1.13; 3.73), which diminished, however, after full adjustment (HR 1.63, 95%-CI: 0.88; 3.02). Furthermore, our results suggest effect modification between walking and sedentary duration, such that in people with low walking duration a high sedentary duration was noted as an independent factor for increased mortality.

Conclusions: In summary, walking duration was clearly associated with four-year overall mortality in community-dwelling older people.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1

Fig 1. Association between walking duration (A) and sedentary duration (B) with mortality adjusted for age, sex, duration of school ≤9 years, smoking status, alcohol intake, BMI, diabetes, hypertension, cardiovascular disease (myocardial infarction, congestive heart failure, stroke), cancer, and chronic kidney disease.

Walking and sedentary duration were modelled as continuous variables and fitted in Cox proportional hazard models using cubic restricted splines with knots at the 5, 35, 65, and 95%.

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