Multimorbidity, mortality, and physical activity

2016 ◽  
Vol 12 (4) ◽  
pp. 272-280 ◽  
Author(s):  
Paul D Loprinzi ◽  
Ovuokerie Addoh ◽  
Chelsea Joyner
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Physical Inactivity ◽  
Self Report ◽  
Minimal Effect ◽  
Increased Risk ◽  
All Cause Mortality ◽  
The Government ◽  
Physician Diagnosis

Objectives Multimorbidity and physical inactivity are individually associated with increased mortality risk, but the possibility for physical activity to moderate the multimorbidity–mortality relationship has yet to be investigated. Methods Data from the 1999–2006 NHANES were employed, with 16,091 participants constituting the analytic sample. Participants were followed through 2011, including a median follow-up of 99 months. Physical activity was assessed via self-report with multimorbidity assessed from physician diagnosis. Results After adjustment, for every 1 morbidity increase, participants had a 23% increased risk of all-cause mortality (HR = 1.23; 95% CI: 1.19–1.28; p < 0.001). Multimorbidity mostly remained associated with all-cause mortality across all levels of physical activity, with the exception of those achieving four times the dose of the government guidelines. Discussion With the exception of those who engaged in high levels of self-reported physical activity, physical activity had a minimal effect on the multimorbidity–mortality relationship.

Accelerometer-Determined Physical Activity and All-Cause Mortality in a National Prospective Cohort Study of Adults Post-Acute Stroke

2017 ◽  
Vol 32 (1) ◽  
pp. 24-27 ◽  
Author(s):  
Paul D. Loprinzi ◽  
Ovuokerie Addoh
Keyword(s):  
Physical Activity ◽  
Self Report ◽  
Proportional Hazard ◽  
Health And Nutrition ◽  
Cox Proportional Hazard ◽  
All Cause Mortality ◽  
Objectively Measured ◽  
Objectively Measured Physical Activity ◽  
Physician Diagnosis

Purpose: No epidemiological study has examined the association of objectively measured physical activity with all-cause mortality among adults who have had a stroke, which was the purpose of this study. Design: Prospective. Setting: National Health and Nutrition Examination Survey 2003 to 2006. Participants: One hundred eighty-four patients with stroke. Measures: Physical activity assessed via accelerometry (ActiGraph 7164), with stroke assessed via self-report of physician diagnosis. Mortality was assessed via linkage with the National Death Index, with follow-up through 2011. Analysis: Cox proportional hazard model. Results: The median follow-up period was 71.96 months, with 13 241 person-months; 53 deaths occurred during this follow-up period. After adjustments, for every 60 min/d increase in total physical activity, adults who have had a stroke had a 28% (hazard ratio = 0.72; 95% confidence interval: 0.59-0.88) reduced risk of all-cause mortality. Conclusion: Physical activity among stroke survivors is inversely associated with all-cause mortality.

Association of Different Physical Activity Domains on All-Cause Mortality in Adults Participating in Primary Care in the Brazilian National Health System: 4-Year Follow-up

2017 ◽  
Vol 14 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Bruna C. Turi ◽  
Jamile S. Codogno ◽  
Romulo A. Fernandes ◽  
Xuemei Sui ◽  
Carl J. Lavie ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Cox Regression ◽  
National Health System ◽  
Circulatory System ◽  
Cox Regression Analysis ◽  
Circulatory System Diseases ◽  
All Cause Mortality ◽  
Males And Females

Background:Evidence has shown that physical activity (PA) is associated with low mortality risk. However, data about reduced mortality due to PA are scarce in developing countries and the dose–response relationship between PA from different domains and all-cause mortality remains unclear. Thus, the aim of this study is to investigate the association of PA from different domains on all-cause mortality among Brazilian adults.Methods:679 males and females composed the study sample. Participants were divided into quartile groups according to PA from different domains (occupational, sports, and leisure-time). Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of PA from different domains and all-cause mortality.Results:During the follow-up period, 59 participants died. The most prevalent cause of death was circulatory system diseases (n = 20; 33.9% [21.8%–45.9%]). Higher scores of occupational (HR= 0.45 [95% CI: 0.20–0.97]), sports (HR= 0.44 [95% CI: 0.20–0.95]) and overall PA (HR= 0.40 [95% CI: 0.17–0.90]) were associated with lower mortality, even after adjustment for confounders.Conclusions:The findings in this study showed the importance of being active in different domains to reduce mortality risk.

Tracking of physical activity during middle school transition in Iranian adolescents

2011 ◽  
Vol 71 (6) ◽  
pp. 631-641 ◽  
Author(s):  
Parvaneh Taymoori ◽  
Tanya R Berry ◽  
David R Lubans
Keyword(s):  
Physical Activity ◽  
High School ◽  
Physical Inactivity ◽  
Physical Activity Behavior ◽  
Self Report ◽  
Psychological Variables ◽  
Interpersonal Influences ◽  
Factors Analysis ◽  
Activity Behavior

Objective: The purpose of this longitudinal study was to examine changes in physical activity behavior, psychological factors and interpersonal influences associated with exercise behavior during the transition from secondary school to high school in Sanandaj, Iran. Design: Data were collected from students in 2006 ( N = 1,073), of whom 844 provided follow-up data in 2009. Setting: The students were in high school in 2009 (51% male) with a mean age of 16.42 ± 1.73 years. Method: Physical activity-related cognitions, interpersonal influences, and physical activity behavior were measured using self-report questionnaires. To assess the effects of time and sex on psychosocial factors, analysis of variances (ANOVAs) were conducted. The relative stability of physical activity psychosocial correlates from wave 1 through wave 2 was assessed using Pearson product-moment correlations. Results: There were significant differences according to sex across time for physical activity, psychological variables and interpersonal influences associated with exercise activities. The girls were less active than boys at both time points. Girls reported lower self-efficacy and perceived more barriers and fewer perceived benefits for physical activity over time. Interpersonal influences on activity were more stable for girls than boys. Conclusion: The results offer evidence for decreasing physical activity in boys and girls and sex differences in cognitive variables and interpersonal influences. This is important for understanding how to address the problem of physical inactivity among Iranian youth.

Light-Intensity Physical Activity and All-Cause Mortality

2016 ◽  
Vol 31 (4) ◽  
pp. 340-342 ◽  
Author(s):  
Paul D. Loprinzi
Keyword(s):  
Physical Activity ◽  
Light Intensity ◽  
Mortality Risk ◽  
Weight Status ◽  
Vigorous Physical Activity ◽  
National Sample ◽  
Poverty Level ◽  
All Cause Mortality ◽  
Intensity Physical Activity

Purpose. Research demonstrates that moderate-to-vigorous physical activity (MVPA) is associated with a reduced risk of all-cause mortality. Few studies have examined the effects of light-intensity physical activity on mortality. Therefore, the purpose of this study was to examine the association between objectively measured light-intensity physical activity and all-cause mortality risk. Design. Longitudinal. Setting. National Health and Nutrition Examination Survey 2003–2006 with follow-up through December 31, 2011. Subjects. Five thousand five hundred seventy-five U.S. adults. Measures. Participants wore an accelerometer for at least 4 days and completed questionnaires to assess sociodemographics and chronic disease information, with blood samples taken to assess biological markers. Follow-up mortality status was assessed via death certificate data from the National Death Index. Analysis. Cox proportional hazard model. Results. After adjusting for accelerometer-determined MVPA, age, gender, race-ethnicity, cotinine, weight status, poverty level, C-reactive protein, and comorbid illness, for every 60-minute increase in accelerometer-determined light-intensity physical activity, participants had a 16% reduced hazard of all-cause mortality (hazard ratio = .84; 95% confidence interval: .78–.91; p < .001). Conclusion. In this national sample of U.S. adults, light-intensity physical activity was inversely associated with all-cause mortality risk, independent of age, MVPA, and other potential confounders. In addition to MVPA, promotion of light-intensity physical activity is warranted.

scholarly journals Can a simple measure of vigorous physical activity predict future mortality? Results from the OXCHECK study

2004 ◽  
Vol 7 (4) ◽  
pp. 557-562 ◽  
Author(s):  
Melvyn Hillsdon ◽  
Margaret Thorogood ◽  
Mike Murphy ◽  
Lesley Jones
Keyword(s):  
Physical Activity ◽  
Cox Regression ◽  
Vigorous Physical Activity ◽  
Previous History ◽  
Self Report ◽  
Moderate Intensity ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Intensity Physical Activity

AbstractBackground:As epidemiological studies have become more complex, demands for short, easily administered measures of risk factors have increased. This study investigates whether such a measure of physical activity is associated with the risk of death from all causes and death from specific causes.Methods:A prospective follow-up study of 11 090 men and women, aged 35–64 years, recruited from five UK general practices who responded to a postal questionnaire in 1989. Self-reported frequency of vigorous-intensity physical activity and data on confounding factors were collected at baseline survey. Death notifications up to 31 December 2001 were provided by the Office for National Statistics. The relative risk (and 95% confidence interval) of dying associated with each level of exposure to physical activity was estimated by the hazard ratio in a series of Cox regression models.Results:After > 10 years' follow-up there were 825 deaths among the 10 522 subjects with no previous history of angina or myocardial infarction. Participation in vigorous exercise was associated with a significantly lower risk of all-cause mortality. Similar associations were found for ischaemic heart disease and cancer mortality, although the relationships were not significant at the 5% level.Conclusions:Simple measures of self-reported vigorous physical activity are associated with the risk of future mortality, at least all-cause mortality in a somewhat selected group. Interpretation of the finding should be treated with caution due to the reliance on self-report and the possibility that residual confounding may underlie the associations. Because moderate-intensity physical activity is also beneficial to health, short physical activity questionnaires should include measures of such physical activity in the future.

scholarly journals Association of BMI, comorbidities and all-cause mortality by using a baseline mortality risk model

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0253696
Author(s):  
Jia Li ◽  
Gyorgy Simon ◽  
M. Regina Castro ◽  
Vipin Kumar ◽  
Michael S. Steinbach ◽  
...  
Keyword(s):  
Body Mass ◽  
Mortality Risk ◽  
Risk Model ◽  
Risk Groups ◽  
Baseline Risk ◽  
Increased Risk ◽  
Wide Range ◽  
Baseline Mortality ◽  
All Cause Mortality

Objective The association of body mass index (BMI) and all-cause mortality is controversial, frequently referred to as a paradox. Whether the cause is metabolic factors or statistical biases is still controversial. We assessed the association of BMI and all-cause mortality considering a wide range of comorbidities and baseline mortality risk. Methods Retrospective cohort study of Olmsted County residents with at least one BMI measurement between 2000–2005, clinical data in the electronic health record and minimum 8 year follow-up or death within this time. The cohort was categorized based on baseline mortality risk: Low, Medium, Medium-high, High and Very-high. All-cause mortality was assessed for BMI intervals of 5 and 0.5 Kg/m2. Results Of 39,739 subjects (average age 52.6, range 18–89; 38.1% male) 11.86% died during 8-year follow-up. The 8-year all-cause mortality risk had a “U” shape with a flat nadir in all the risk groups. Extreme BMI showed higher risk (BMI <15 = 36.4%, 15 to <20 = 15.4% and ≥45 = 13.7%), while intermediate BMI categories showed a plateau between 10.6 and 12.5%. The increased risk attributed to baseline risk and comorbidities was more obvious than the risk based on BMI increase within the same risk groups. Conclusions There is a complex association between BMI and all-cause mortality when evaluated including comorbidities and baseline mortality risk. In general, comorbidities are better predictors of mortality risk except at extreme BMIs. In patients with no or few comorbidities, BMI seems to better define mortality risk. Aggressive management of comorbidities may provide better survival outcome for patients with body mass between normal and moderate obesity.

scholarly journals Hours lying down per day, as a proxy for sedentary behaviour and risk of diabetes in young and middle-aged adults in Norway: an 11-year follow-up of the HUNT study

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e035010
Author(s):  
Ernest O Asante ◽  
Yi-Qian Sun ◽  
Tom Ivar Lund Nilsen ◽  
Bjørn Olav Åsvold ◽  
Elin Pettersen Sørgjerd ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Leisure Time Physical Activity ◽  
Self Report ◽  
Incident Diabetes ◽  
Middle Aged ◽  
Increased Risk ◽  
Middle Aged Adults ◽  
Lying Down

ObjectiveWe aimed to examine relationship between hours lying down per day, as a proxy for sedentary behaviour and risk of diabetes in young and middle-aged adults, and to assess if leisure-time physical activity and body mass index (BMI) modified this relationship.DesignA population-based prospective cohort study.SettingNord-Trøndelag, Norway.ParticipantsThe cohort included 17 058 diabetes-free adults, at an age of 20–55 years in 1995–1997, who were followed-up to 2006–2008.Primary outcome measuresIncident diabetes was defined by self-report of diabetes or non-fasting glucose levels greater than 11 mmol/L at the follow-up.MethodsMultivariable logistic regression models were used to obtain OR with 95% CI for risk of diabetes by the categories of hours lying down (≤7, 8 and ≥9 hours/day).Results362 individuals (2.1%) developed diabetes during an average of 11-year follow-up. Individuals who reported lying down ≥9 hours/day had an adjusted OR of 1.35 (95% CI 1.01 to 1.80) for incident diabetes compared with those lying down 8 hours/day. Lying down ≤7 hours/day was not associated with the risk of diabetes. In analysis stratified by physical activity, the ORs associated with lying down ≥9 hours/day were 1.41 (95% CI 1.05 to 1.90) and 0.90 (95% CI 0.23 to 3.55), respectively, among the less active and highly active individuals (pinteraction=0.048). There was little evidence that the association differed by BMI status (pinteraction=0.62).ConclusionsProlonged hours lying down per day was associated with an increased risk of diabetes in young and middle-aged adults. The positive association appeared to be modified by physical activity but not by BMI.

An analysis of the impact of fluid overload and fluid depletion for all-cause and cardiovascular mortality

2019 ◽  
Vol 34 (8) ◽  
pp. 1385-1393 ◽  
Author(s):  
Dimitrie Siriopol ◽  
Mihaela Siriopol ◽  
Stefano Stuard ◽  
Luminita Voroneanu ◽  
Peter Wabel ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Fluid Overload ◽  
Reference Group ◽  
Volume Status ◽  
Time Varying ◽  
Dialysis Fluid ◽  
Fluid Status ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Background Both baseline fluid overload (FO) and fluid depletion are associated with increased mortality risk and cardiovascular complications in haemodialysis patients. Fluid status may vary substantially over time, and this variability could also be associated with poor outcomes. Methods In our retrospective cohort study, including 4114 haemodialysis patients from 34 Romanian dialysis units, we investigated both all-cause and cardiovascular mortality risk according to baseline pre- and post-dialysis volume status, changes in pre- and post-dialysis fluid status during follow-up (time-varying survival analysis), pre–post changes in volume status during dialysis and pre-dialysis fluid status variability during the first 6 months of evaluation. Results According to their pre-dialysis fluid status, patients were stratified in the following groups: normovolaemic with an absolute FO (AFO) compartment between −1.1 and 1.1 L, fluid depletion with an AFO below −1.1 L, moderate FO with an AFO compartment >1.1 but <2.5 L and severe FO with the AFO compartment >2.5 L. Baseline pre-dialysis FO and fluid depletion patients had a significantly elevated risk of all-cause mortality risk {hazard ratio [HR] 1.53 [95% confidence interval (CI) 1.22–1.93], HR 2.04 (95% CI 1.59–2.60) and HR 1.88 (95% CI 1.07–3.39) for moderate FO, severe FO and fluid depletion, respectively}. In contrast, post-dialysis fluid depletion was associated with better survival [HR 0.71 (95% CI 0.57–0.89)]. Similar results were found when using changes in pre- or post-dialysis fluid status during follow-up (time-varying values): FO patients had an increased risk of all-cause [moderate FO: HR 1.39 (95% CI 1.11–1.75); severe FO: HR 2.29 (95% CI 2.01–3.31] and cardiovascular (CV) mortality [moderate FO: HR 1.34 (95% CI 1.05–1.70); severe FO: HR 2.34 (95% CI 1.67–3.28)] as compared with normohydrated patients. Using pre–post changes in volume status during dialysis, we categorized the patients into six groups: Group 1, AFO <−1.1 L pre- and post-dialysis; Group 2, AFO between −1.1 and 1.1 L pre-dialysis and <−1.1 L post-dialysis (the reference group); Group 3, AFO between −1.1 and 1.1 L pre- and post-dialysis; Group 4, AFO >1.1 L pre-dialysis and <−1.1 L post-dialysis; Group 5, AFO >1.1 L pre-dialysis and between −1.1 and 1.1 L post-dialysis; Group 6, AFO >1.1 L pre- and post-dialysis. Using the baseline values, only patients in Groups 1, 5 and 6 maintained an increased risk for all-cause mortality as compared with the reference group. Additionally, CV mortality risk was significantly higher for patients in Groups 5 and 6. When we applied the time-varying analysis, patients in Groups 1, 5 and 6 had a significantly higher risk for both all-cause and CV mortality risk. In the last approach, the highest risk for the all-cause mortality outcome was observed for patients with high-amplitude fluctuation during the first 6 months of evaluation [HR 2.75 (95% CI 1.29–5.84)]. Conclusion We reconfirm the association between baseline pre- and post-dialysis volume status and mortality in dialysis patients; additionally, we showed that greater fluid status variability is independently associated with higher mortality.

Effects of Physical Inactivity on All-Cause Mortality Risk in Upper Bavaria

1993 ◽  
Vol 77 (2) ◽  
pp. 499-505 ◽  
Author(s):  
Siegfried Weyerer
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Reference Group ◽  
Physical And Mental Health ◽  
Crude Mortality ◽  
Confounding Variables ◽  
All Cause Mortality ◽  
Representative Random Sample ◽  
Physically Inactive

The effect of physical activity on all-cause mortality was examined using a representative random sample of 1,536 persons (15 years and older) in three communities in Upper Bavaria. 27.0% of the respondents reported regular and 26.2% occasional physical exercise. During the 5-year follow-up 5.1% ( n = 79) of the original sample died. Using a logistic regression model, the relation between physical activity and mortality was measured by the odds ratio, with subjects reporting regular physical activity as the reference group. Crude mortality risk was significantly higher among the physically inactive (men: 3.97; women: 4.36) but not among respondents practising occasionally (men: 1.67; women: 1.24). After adjustment for potential confounding variables (age, social class, physical and mental health), the mortality risk was elevated but not statistically significant for the physically inactive (men: 1.76; women: 1.51) and for the group practising occasionally (men: 1.50; women: 1.14).

scholarly journals Low serum klotho associated with all-cause mortality among a nationally representative sample of American adults

2021 ◽  
Author(s):  
Jacob K Kresovich ◽  
Catherine M Bulka
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Representative Sample ◽  
Cox Regression ◽  
The United States ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Nationally Representative ◽  
Low Serum

Abstract α-Klotho (klotho) is a protein involved in suppressing oxidative stress and inflammation. In animal models, it is reported to underlie numerous aging phenotypes and longevity. Among a nationally representative sample of adults aged 40 to 79 in the United States, we investigated whether circulating concentrations of klotho is a marker of mortality risk. Serum klotho was measured by ELISA on 10,069 individuals enrolled in the National Health and Nutrition Examination Survey between 2007-2014. Mortality follow-up data based on the National Death Index were available through December 31, 2015. After a mean follow-up of 58 months (range: 1-108), 616 incident deaths occurred. Using survey-weighted Cox regression models adjusted for age, sex and survey cycle, low serum klotho concentration (&lt; 666 pg/mL) was associated with a 31% higher risk of death (compared to klotho concentration &gt; 985 pg/mL, HR: 1.31, 95% CI: 1.00, 1.71, P= 0.05). Associations were consistent for mortality caused by heart disease or cancer. Associations of klotho with all-cause mortality did not appear to differ by most participant characteristics. However, we observed effect modification by physical activity, such that low levels of serum klotho were more strongly associated with mortality among individuals who did not meet recommendation-based physical activity guidelines. Our findings suggest that, among the general population of American adults, circulating levels of klotho may serve as a marker of mortality risk.

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