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

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).

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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

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0067 ◽

2017 ◽

Vol 14 (1) ◽

pp. 45-51 ◽

Cited By ~ 3

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.

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Light-Intensity Physical Activity and All-Cause Mortality

American Journal of Health Promotion ◽

10.4278/ajhp.150515-arb-882 ◽

2016 ◽

Vol 31 (4) ◽

pp. 340-342 ◽

Cited By ~ 35

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.

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Multimorbidity, mortality, and physical activity

Chronic Illness ◽

10.1177/1742395316644306 ◽

2016 ◽

Vol 12 (4) ◽

pp. 272-280 ◽

Cited By ~ 12

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.

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

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfy396 ◽

2019 ◽

Vol 34 (8) ◽

pp. 1385-1393 ◽

Cited By ~ 3

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.

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

The Journals of Gerontology Series A ◽

10.1093/gerona/glab308 ◽

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 (< 666 pg/mL) was associated with a 31% higher risk of death (compared to klotho concentration > 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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The Relationship of Accelerometer-Assessed Standing Time With and Without Ambulation and Mortality: The WHI OPACH Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa227 ◽

2020 ◽

Vol 76 (1) ◽

pp. 77-84

Author(s):

Purva Jain ◽

John Bellettiere ◽

Nicole Glass ◽

Michael J LaMonte ◽

Chongzhi Di ◽

...

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Community Dwelling ◽

Machine Learning Algorithms ◽

Cardiovascular Health Study ◽

Accelerometer Data ◽

All Cause Mortality

Abstract Background Self-reported time spent standing has been associated with lower risk of mortality. No previous studies have examined this association using device-measured standing. Method This was a prospective cohort study of 5878 older (median age = 80 years), racial/ethnically diverse, community-dwelling women in the WHI Objective Physical Activity and Cardiovascular Health Study (OPACH). Women wore accelerometers for 1 week and were followed for mortality. The study applied previously validated machine learning algorithms to ActiGraph GT3X+ accelerometer data to separately measure time spent standing with and without ambulation. Cox proportional hazards models were used to estimate mortality risk adjusting for potential confounders. Effect modification by age, body mass index, moderate-to-vigorous physical activity, sedentary time, physical functioning, and race/ethnicity was evaluated. Results There were 691 deaths during 26 649 person-years of follow-up through March 31, 2018 (mean follow-up = 4.8 years). In fully adjusted models, all-cause mortality risk was lower among those with more standing without ambulation (quartile [Q] 4 vs Q1 HR = 0.63; 95% CI = 0.49–0.81, p-trend = .003) and more standing with ambulation (Q4 vs Q1 HR = 0.50; 95% CI = 0.35–0.71, p-trend < .001). Associations of standing with ambulation and mortality were stronger among women with above-median sedentary time (HR = 0.51; 95% CI = 0.38–0.68) compared to women with below-median sedentary time (HR = 0.80; 95% CI = 0.59–1.07; p-interaction = .02). Conclusions In this prospective study among older women, higher levels of accelerometer-measured standing were associated with lower risks of all-cause mortality. Standing is an achievable approach to interrupting prolonged sedentary time, and if not contraindicated, is a safe and feasible behavior that appears to benefit health in older ages.

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Systolic blood pressure and all-cause mortality in normoglycemia, prediabetes, and diabetes

10.21203/rs.3.rs-25078/v1 ◽

2020 ◽

Author(s):

Chao-lei Chen ◽

Lin Liu ◽

Jia-yi Huang ◽

Yu-ling Yu ◽

Kenneth Lo ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Mortality Risk ◽

Cox Regression ◽

Reference Group ◽

Diabetic Patients ◽

Diabetes Status ◽

All Cause Mortality ◽

Glucose Status

Abstract Background The optimal blood pressure (BP) level for diabetic patients remains controversial, and population-based evidence on BP management for individuals with normoglycemia and prediabetes is insufficient. We aimed to investigate the associations between systolic blood pressure (SBP) and all-cause mortality among US adults with different glucose metabolism.Methods We used data from the 1999–2014 National Health and Nutrition Examination Survey (NHANES, n = 40,046) with comprehensive baseline examination and follow-up assessment. Restricted cubic spline was performed to examine dose-response relationship between continuous SBP and all-cause mortality. Cox regression models were used to estimate hazard ratios of all-cause mortality for SBP categories.Results Over 32,5450 person-years of follow-up (median 8.1 years), 4745 all-cause death (11.8%) were recorded, corresponding to an event rate of 14.58 per 1000 patient years. U-shaped associations between SBP and all-cause mortality were observed regardless of glucose status. The lowest mortality risk of optimal SBP (mmHg) by group was 115–120 (normoglycemia), 120–130 (prediabetes), and 125–135 (diabetes). Compared with the reference group, SBP < 100 mmHg was significantly associated with 49% (HR = 1.49, 95%CI: 1.13–1.96), 57% (1.57, 1.07–2.3), and 59% (1.59, 1.12–2.25) higher mortality risk in normoglycemia, prediabetes, and diabetes, respectively. The multivariable-adjusted HRs of all-cause mortality for SBP of 150–159 mmHg and ≥ 160 mmHg were 1.35 (1.08–1.70) and 1.61 (1.31–1.98), 1.44 (1.13–1.83) and 1.66 (1.33–2.08), and 1.29 (1.02–1.65) and 1.37 (1.09–1.72), respectively.Conclusions U-shaped relationships between SBP and all-cause mortality existed regardless of diabetes status. The optimal SBP range for the lowest mortality was gradually higher with worsening glucose status.

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Physical Activity–Related Obesity Risk Classification Model and All-Cause Mortality

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0091 ◽

2016 ◽

Vol 13 (11) ◽

pp. 1255-1262 ◽

Cited By ~ 2

Author(s):

Paul D. Loprinzi ◽

Ovuokerie Addoh

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Mortality Risk ◽

Risk Identification ◽

Classification Model ◽

Obesity Risk ◽

Respective Group ◽

All Cause Mortality ◽

Objectively Measured

Background:This study evaluated a physical activity–related obesity model on mortality.Methods:Data from the 1999–2006 NHANES were used (N = 16,077), with follow-up through 2011. Physical activity (PA) was subjectively assessed, with body mass index (BMI) and waist circumference (WC) objectively measured. From these, 12 mutually exclusive groups (G) were evaluated, including: G1: Normal BMI, Normal WC and Active; G2: Normal BMI, Normal WC and Inactive; G3: Normal BMI, High WC and Active; G4: Normal BMI, High WC and Inactive; G5: Overweight BMI, Normal WC and Active; G6: Overweight BMI, Normal WC and Inactive; G7: Overweight BMI, High WC and Active; G8: Overweight BMI, High WC and Inactive; G9: Obese BMI, Normal WC and Active; G10: Obese BMI, Normal WC and Inactive; G11: Obese BMI, High WC and Active; and G12: Obese BMI, High WC and Inactive.Results:Compared with G2, the following had a reduced mortality risk: G1, G3, G5, G6, G7, G8, G9, and G11. Compared with G12, the following had a reduced mortality risk: G1, G3, G5, G7, G9, and G11. In each respective group for BMI and WC, the active group had a reduced mortality risk.Conclusions:Across all BMI and WC combinations, PA improved mortality risk identification.

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Association of physical activity intensity and bout length with mortality: An observational study of 79,503 UK Biobank participants

PLoS Medicine ◽

10.1371/journal.pmed.1003757 ◽

2021 ◽

Vol 18 (9) ◽

pp. e1003757

Author(s):

Lousise A. C. Millard ◽

Kate Tilling ◽

Tom R. Gaunt ◽

David Carslake ◽

Deborah A. Lawlor

Keyword(s):

Physical Activity ◽

Mortality Risk ◽

Sedentary Time ◽

The United States ◽

Lower Mortality ◽

Uk Biobank ◽

Bout Length ◽

All Cause Mortality ◽

Light Activity

Background Spending more time active (and less sedentary) is associated with health benefits such as improved cardiovascular health and lower risk of all-cause mortality. It is unclear whether these associations differ depending on whether time spent sedentary or in moderate-vigorous physical activity (MVPA) is accumulated in long or short bouts. In this study, we used a novel method that accounts for substitution (i.e., more time in MVPA means less time sleeping, in light activity or sedentary) to examine whether length of sedentary and MVPA bouts associates with all-cause mortality. Methods and findings We used data on 79,503 adult participants from the population-based UK Biobank cohort, which recruited participants between 2006 and 2010 (mean age at accelerometer wear 62.1 years [SD = 7.9], 54.5% women; mean length of follow-up 5.1 years [SD = 0.73]). We derived (1) the total time participants spent in activity categories—sleep, sedentary, light activity, and MVPA—on average per day; (2) time spent in sedentary bouts of short (1 to 15 minutes), medium (16 to 40 minutes), and long (41+ minutes) duration; and (3) MVPA bouts of very short (1 to 9 minutes), short (10 to 15 minutes), medium (16 to 40 minutes), and long (41+ minutes) duration. We used Cox proportion hazards regression to estimate the association of spending 10 minutes more average daily time in one activity or bout length category, coupled with 10 minutes less time in another, with all-cause mortality. Those spending more time in MVPA had lower mortality risk, irrespective of whether this replaced time spent sleeping, sedentary, or in light activity, and these associations were of similar magnitude (e.g., hazard ratio [HR] 0.96 [95% CI: 0.94, 0.97; P < 0.001] per 10 minutes more MVPA, coupled with 10 minutes less light activity per day). Those spending more time sedentary had higher mortality risk if this replaced light activity (HR 1.02 [95% CI: 1.01, 1.02; P < 0.001] per 10 minutes more sedentary time, with 10 minutes less light activity per day) and an even higher risk if this replaced MVPA (HR 1.06 [95% CI: 1.05, 1.08; P < 0.001] per 10 minutes more sedentary time, with 10 minutes less MVPA per day). We found little evidence that mortality risk differed depending on the length of sedentary or MVPA bouts. Key limitations of our study are potential residual confounding, the limited length of follow-up, and use of a select sample of the United Kingdom population. Conclusions We have shown that time spent in MVPA was associated with lower mortality, irrespective of whether it replaced time spent sleeping, sedentary, or in light activity. Time spent sedentary was associated with higher mortality risk, particularly if it replaced MVPA. This emphasises the specific importance of MVPA. Our findings suggest that the impact of MVPA does not differ depending on whether it is obtained from several short bouts or fewer longer bouts, supporting the recent removal of the requirement that MVPA should be accumulated in bouts of 10 minutes or more from the UK and the United States policy. Further studies are needed to investigate causality and explore health outcomes beyond mortality.

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