Quantifying the time-varying association between objectively measured physical activity and mortality in US older adults over a 12-year follow-up period: the NHANES 2003-2006 study

BMJ Evid Based Med. 2024 Nov 22;29(6):409-414. doi: 10.1136/bmjebm-2023-112303.

Abstract

Objectively measuring physical activity (PA) has consistently shown an association with reduced all-cause mortality risk in cross-sectional studies. However, the strength of this association may change over time. We quantify the time-varying, covariate-adjusted association between the total volume of PA and all-cause mortality over a 12-year follow-up period using Cox regression with a time varying effect of population-referenced quantile total activity count adjusted for traditional risk factors. Analyses focus on participants 50-84 years old with adequate accelerometer wear time and without missing covariates. The findings suggest that (1) the use of baseline PA in Cox models with long follow-up periods may be inappropriate without time-varying effects and (2) the use of accelerometry derived volume of PA in risk score calculations may be most appropriate for short-term to medium-term risk scores.

Keywords: Behavioral Disciplines and Activities; Health Planning; Methods; Physical Fitness; Public health.

MeSH terms

  • Accelerometry*
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Exercise*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Nutrition Surveys*
  • Proportional Hazards Models
  • Risk Factors
  • Time Factors
  • United States / epidemiology