Physical activity combined with sedentary behaviour in the risk of mortality in older adults

Galvão, Lucas Lima; Silva, Rizia Rocha; Tribess, Sheilla; Santos, Douglas Assis Teles; Virtuoso Junior, Jair Sindra

doi:10.11606/s1518-8787.2021055003461

Brasil

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Original Article • Rev. Saúde Pública 55 • 2021 • https://doi.org/10.11606/s1518-8787.2021055003461 linkcopy

Physical activity combined with sedentary behaviour in the risk of mortality in older adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To examine the effects of physical activity (PA) and sedentary behaviour (SB), in isolation and combination, on all-cause mortality in older adults.

METHODS Prospective, population-based cohort study. The data were collected from first wave in 2015 and the follow-up continued until 2020. The sample consisted of 332 older adult people aged ≥ 60 years-old, out of which 59 died. The level of PA and SB was assessed by the International Physical Activity Questionnaire (IPAQ). The older adults were divided into PA categorized as sufficiently active and insufficiently active and into high and low SB. We built four combinations of PA and SB. Also, we used the Cox proportional hazards regression with a 95% confidence interval with hazard ratio estimate so as to verify the mortality risks between PA, SB, and the combinations of PA and SB.

RESULTS Insufficiently active individuals had higher risks of mortality compared to sufficiently active people. We observed no associations between SB and mortality separately; however, when evaluated in a combined way, insufficiently active individuals and with a high SB time had a higher chance of mortality compared to active individuals with a low SB time.

CONCLUSION Our isolated analyses demonstrate that complying with PA recommendations reduces the risk of mortality; however, no association was found between the time of PA exposure with the time of SB. When analysing the combination, being physically inactive and with a long time of SB showed higher mortality rates, with SB being an enhancer of this risk. The results of this study show the interdependence of SB for PA performed at moderate to vigorous intensity. The understanding of this interrelation must be considered in the formulation of public health guidelines.

Aged; Sedentary Behavior; Exercise; Risk Factors; Mortality

	Alive		Deceased		p

	n	%	n	%
Gender					0.655
Male	98	81.0	23	19.0
Female	175	82.2	36	17.1
Home arrangement					0.871
Without partner	142	82.6	30	17.4
With partner	131	81.9	30	18.1
Perception of health					0.171
Positive	109	85.8	18	14.2
Negative	163	79.9	41	20.1
Physical Activity					< 0.001
≥ 150min/week	157	90.8	16	9.2
< 150 min/week	116	73.0	43	27.0
Sedentary Behavior					0.002
< 540 min/day	211	86.1	34	13.9
≥ 540 min/day	62	71.3	25	28.7
Smoking history					0.269
No	245	83.1	50	16.9
Yes	28	75.5	9	24.3

	Median	SE	Median	SE

Age	67.0	0.46	78.0	1.25	< 0.001
Number of diseases	3.0	0.16	3,0	0.39	0.025
Body mass index kg/m²	26.82	0.32	25.72	0.71	0.021

Variable	Hazard Ratio (CI 95%)

	Model 1^a	p	Model 2^b	p	Model 3^c	p	Model 4^d	p
Physical activity		< 0.001		0.009		0.009		0.014
≥ 150min/week	1		1		1		1
< 150 min/week	3.56 (1.94–6.54)		2.34 (1.23–4.47)		2.35 (1.23–4.49)		2.29 (1.18–4.44)
Sedentary behaviour		0.006		0.025		0.037		0.063
< 540 min/day	1		1		1		1
≥ 540 min/day	2.13 (1.24–3.65)		1.99 (1.16–3.43)		1.81 (1.03–3.17)		1.71 (0.97–3.02)
PA and SB combinations		< 0.001		< 0.001		< 0.001		< 0.001
≥ 150 min/week e < P75 min/day	1		1		1		1
≥ 150 min/week e ≥ P75 min/day	1.05 (0.23–4.70)		1.02 (0.22–4.56)		0.93 (0.20–4.19)		0.88 (0.19–4.01)
< 150 min/week e < P75 min/day	2.88 (1.41–5.86)		1.78 (0.84–3.76)		1.83 (0.86–3.89)		1.81 (0.84–3.89)
< 150 min/week e ≥ P75 min/day	4.85 (2.37–9.92)		3.36 (1.60–7.06)		3.10 (1.46–6.58)		2.92 (1.36–6.26)

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[TFN1] SE: standard error.