Dataset Information

Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality.

ABSTRACT: INTRODUCTION:It is well established that physical activity (PA) protects against mortality and morbidity, but how long-term patterns of PA are associated with mortality and cardiovascular disease (CVD) remains unclear. METHODS:3231 men recruited to the British Regional Heart Study, a prospective cohort study, reported usual PA levels at baseline in 1978-1980 (aged 40-59 years) and at 12-year, 16-year and 20-year follow ups. Twenty-year trajectories of PA, spanning from 1978/1980 to 2000, were identified using group-based trajectory modelling. Men were subsequently followed up until 30 June 2016 for mortality through National Health Service central registers and for non-fatal CVD events through primary and secondary care records. Data analyses were conducted in 2019. RESULTS:Three PA trajectories were identified: low/decreasing (22.7%), light/stable (51.0%) and moderate/increasing (26.3%). Over a median follow-up of 16.4 years, there were 1735 deaths. Compared with the low/decreasing group, membership of the light/stable (HR 0.83, 95%?CI 0.74 to 0.94) and moderate/increasing (HR 0.76, 95%?CI 0.66 to 0.88) groups was associated with a lower risk of all-cause mortality. Similar associations were observed for CVD mortality, major coronary heart disease and all CVD events. Associations were only partially explained by a range of confounders. Sensitivity analyses suggested that survival benefits were largely driven by most recent/current PA. CONCLUSIONS:A dose-response relationship was observed, with higher levels of PA from midlife to old age associated with additional benefits. However, even fairly modest and sustained PA was protective and may be more achievable for the most inactive.

SUBMITTER: Aggio D

PROVIDER: S-EPMC6993021 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality.

Aggio Daniel D Papachristou Efstathios E Papacosta Olia O Lennon Lucy T LT Ash Sarah S Whincup Peter P Wannamethee S Goya SG Jefferis Barbara J BJ

Journal of epidemiology and community health 20191108 2

<h4>Introduction</h4>It is well established that physical activity (PA) protects against mortality and morbidity, but how long-term patterns of PA are associated with mortality and cardiovascular disease (CVD) remains unclear.<h4>Methods</h4>3231 men recruited to the British Regional Heart Study, a prospective cohort study, reported usual PA levels at baseline in 1978-1980 (aged 40-59 years) and at 12-year, 16-year and 20-year follow ups. Twenty-year trajectories of PA, spanning from 1978/1980 t ...[more]

PMID: 31704805

Similar Datasets

Project description:ObjectivesTo examine cumulative associations between midlife health behaviors and walking speed and upper-limb strength in early old age.DesignProspective cohort study.SettingWhitehall II Study.ParticipantsIndividuals (mean age 49.1 ± 5.9 in 1991-93) with health behavior data for at least two of the three assessments (1991-93, 1997-99, 2002-04) and physical functioning measures in 2007-09 (mean age 65.9 ± 5.9) (N = 5,671).MeasurementsA trained nurse assessed walking speed and upper-limb strength. Unhealthy behaviors were defined as current or recent smoking, nonmoderate alcohol consumption (abstinence or heavy drinking), fruit and vegetable consumption less than twice per day, and physical inactivity (<1 h/wk of moderate and <1 h/wk of vigorous physical activity). For each unhealthy behavior, a cumulative score was calculated as the number of times a person reported the behavior over the three assessments divided by 3. The score ranged between 0 (never) and 1 (all three times).ResultsIn linear regression models adjusted for age, sex, education, marital status, and height, all unhealthy behaviors in 1991-93 were associated with slower walking speed in 2007-09, with differences ranging from 0.10 (nonmoderate alcohol consumption) to 0.25 (physical inactivity) of a standard deviation between participants with and without the unhealthy behavior (Pt-test <.001). For walking speed, the accumulation-of-risk model provided the best fit for unhealthy diet (β for a 1-point increment in the low fruit and vegetable consumption score = -0.29, 95% confidence interval (CI) = -0.36 to -0.22) and physical inactivity (β = -0.37, 95% CI = -0.45 to -0.29). For smoking and nonmoderate alcohol consumption, a cumulative effect was also observed, but partial F-tests did not suggest that it provided a better fit than models with behaviors in 1991-93, 1997-99, or 2002-04. All behavioral scores except smoking were associated with grip strength, but F-tests supported the accumulation-of-risk hypothesis only for physical inactivity.ConclusionThese findings highlight the importance of duration of unhealthy behaviors, particularly for diet and physical activity, when examining associations with physical functioning.

Project description:PurposeConduct a systematic umbrella review to evaluate the relationship of physical activity (PA) with all-cause mortality, cardiovascular mortality, and incident cardiovascular disease (CVD); to evaluate the shape of the dose-response relationships; and to evaluate these relationships relative to the 2008 Physical Activity Guidelines Advisory Committee Report.MethodsPrimary search encompassing 2006 to March, 2018 for existing systematic reviews, meta-analyses, and pooled analyses reporting on these relationships. Graded the strength of evidence using a matrix developed for the Physical Activity Guidelines Advisory Committee.ResultsThe association of self-reported moderate-to-vigorous physical activity (MVPA) on all-cause mortality, CVD mortality, and atherosclerotic CVD-including incident coronary heart disease, ischemic stroke and heart failure-are very similar. Increasing MVPA to guidelines amounts in the inactive US population has the potential to have an important and substantial positive impact on these outcomes in the adult population. The following points are clear: the associations of PA with beneficial health outcomes begin when adopting very modest (one-third of guidelines) amounts; any MVPA is better than none; meeting the 2008 PA guidelines reduces mortality and CVD risk to about 75% of the maximal benefit obtained by physical activity alone; PA amounts beyond guidelines recommendations amount reduces risk even more, but greater amounts of PA are required to obtain smaller health benefits; and there is no evidence of excess risk over the maximal effect observed at about three to five times the amounts associated with current guidelines. When PA is quantified in terms of energy expenditure (MET·h·wk), these relationships hold for walking, running, and biking.ConclusionsTo avoid the risks associated with premature mortality and the development of ischemic heart disease, ischemic stroke, and all-cause heart failure, all adults should strive to reach the 2008 Physical Activity Guidelines for Americans.

Dataset Information

Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality.

Publications

Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets