Association of daily composition of physical activity and sedentary behaviour with incidence of cardiovascular disease in older adults

Abstract

Background Moderate-to-vigorous physical activity (MVPA) is proposed as key for cardiovascular diseases (CVD) prevention. At older ages, the role of sedentary behaviour (SB) and light intensity physical activity (LIPA) remains unclear. Evidence so far is based on studies examining movement behaviours as independent entities ignoring their co-dependency. This study examines the association between daily composition of objectively-assessed movement behaviours (MVPA, LIPA, SB) and incident CVD in older adults. Methods Whitehall II accelerometer sub-study participants free of CVD at baseline (N = 3319, 26.7% women, mean age = 68.9 years in 2012–2013) wore a wrist-accelerometer from which times in SB, LIPA, and MVPA during waking period were extracted over 7 days. Compositional Cox regression was used to estimate the hazard ratio (HR) for incident CVD for daily compositions of movement behaviours characterized by 10 (20 or 30) minutes greater duration in one movement behaviour accompanied by decrease in another behaviour, while keeping the third behaviour constant, compared to reference composition. Analyses were adjusted for sociodemographic, lifestyle, cardiometabolic risk factors and multimorbidity index. Results Of the 3319 participants, 299 had an incident CVD over a mean (SD) follow-up of 6.2 (1.3) years. Compared to daily movement behaviour composition with MVPA at recommended 21 min per day (150 min/week), composition with additional 10 min of MVPA and 10 min less SB was associated with smaller risk reduction – 8% (HR, 0.92; 95% CI, 0.87–0.99) – than the 14% increase in risk associated with a composition of similarly reduced time in MVPA and more time in SB (HR, 1.14; 95% CI, 1.02–1.27). For a given MVPA duration, the CVD risk did not differ as a function of LIPA and SB durations. Conclusions Among older adults, an increase in MVPA duration at the expense of time in either SB or LIPA was found associated with lower incidence of CVD. This study lends support to public health guidelines encouraging increase in MVPA or at least maintain MVPA at current duration.

Objectively Measured Total Sedentary Time and Pattern of Sedentary Accumulation in Older Adults: Associations With Incident Cardiovascular Disease and All-Cause Mortality

“…In contrast using objectively assessed SB, the Objective Physical Activity and Cardiovascular Health (OPACH) study of older women found a linear dose–response relationship where each 1 additional hour of sedentary time was associated with 12% higher CVD risk ( 18 ) in model accounting for multiple risk factors and MVPA. In other studies the associations were attenuated on adjustment with higher intensity PA ( 17 ), health-related factors ( 41 , 42 ), or both ( 40 ), as also found in our study.…”

“…11,12 In this study we examined associations of multiple sedentary accumulation pattern measures with both outcomes, given that different metrics might be indicative of distinct features of SB. Based on our findings, we reiterate the importance of MVPA for CVD prevention, 42 as associations of total sedentary time and accumulation patterns with CVD risk were no more evident once MVPA was considered. In addition, there was evidence of higher all-cause mortality risk with increased total and less fragmented sedentary time independently from MVPA in the younger older adults.…”

“…Studies based on self-reported measures 38,39 have found higher sedentary time to be associated with increased risk of CVD incidence, while conclusions are mixed for the limited number of studies using objective measures. 17,18,[40][41][42] A pooled analysis of 9 prospective studies, mean age of 54.4 years and median follow-up of 11 years, reported a non-linear A c c e p t e d M a n u s c r i p t association of questionnaire assessed sedentary time with CVD incidence, with the increase in risk observed only at a duration greater than 10 hours/day, when adjusted for PA. 38 In contrast using objectively-assessed SB, the Objective Physical Activity and Cardiovascular Health (OPACH) study of older women found a linear dose-response relationship where each 1 additional hour of sedentary time was associated with 12% higher CVD risk 18 in model accounting for multiple risk factors and MVPA. In other studies the associations were attenuated on adjustment with higher intensity PA, 17 health-related factors 41,42 or both, 40 as also found in our study.…”

Prevalence and Correlates of Insufficient Physical Activity Among Adults Aged 18–69 Years in India: Findings From the National Noncommunicable Disease Monitoring Survey

“…51 A recent study demonstrated that an increase in moderate-intensity PA would reduce the incidence of CVD. 52 Present study findings demonstrate that insufficient PA contributed to a greater 10year CVD risk in Indians. Evidence suggests that sufficient levels of PA reduce the possible risk of development of NCDs.…”

Factors Associated with Cardiovascular Disease Risk among Employees at a Portuguese Higher Education Institution

“…One of the risk factors most alarmingly associated with work is sedentary lifestyle because most jobs have a fixed schedule associated with a specific location. With advanced age, this tendency towards sedentary habits increases, particularly when associated with the time each individual spends sitting per day [ 65 , 66 , 67 ]. In this study, we deal with an aging work population (70.7% are aged between 45 and 64 years).…”