Physical activity profiles and glucose metabolism — A population‐based cross‐sectional study in older adults

Cardiovascular disease risk and all-cause mortality associated with accelerometer-measured physical activity and sedentary time ‒ a prospective population-based study in older adults

Background

Low levels of physical activity (PA) and high sedentary time (ST) are common in older adults and lack of PA is a risk factor for cardiovascular disease (CVD). Knowledge about associations with accelerometer-measured PA, ST and CVD risk in older adults is insufficient. This study examines the associations of accelerometer-measured PA and ST with cardiovascular risk measured using the Framingham risk score (FRS) and all-cause mortality in older adults.

Methods

A population-based sample of 660 (277 men, 383 women) older people (mean age 68.9) participated in the Oulu45 cohort study from 2013‒2015. PA and ST were measured with wrist-worn accelerometers at baseline for two weeks. Ten-year CVD risk (%) was estimated with FRS. The data for all-cause mortality were identified from the Digital and Population Data Services Agency, Finland after an average of 6.2 years follow-up. The associations between moderate to vigorous physical activity (MVPA), light physical activity (LPA), ST and FRS were analyzed using the multivariable linear regression analysis. Associations between LPA, ST and mortality were analyzed using the Cox proportional-hazard regression models.

Results

Each 10 min increase in MVPA (β = -0.779, 95% CI -1.186 to -0.371, p < 0.001) and LPA (β = -0.293, 95% CI -0.448 to -0.138, p < 0.001) was negatively associated with FRS while a 10 min increase in ST (β = 0.290, 95% CI 0.158 to 0.421, p < 0.001) was positively associated with FRS. After adjustment for waist circumference, only ST was significantly associated with FRS. Each 10 min increase in LPA was associated with 6.5% lower all-cause mortality risk (HR = 0.935, 95% CI 0.884 to 0.990, p = 0.020) and each 10 min increase in ST with 5.6% increased mortality risk (HR = 1.056, 95% CI 1.007 to 1.108, p = 0.025).

Conclusion

A higher amount of daily physical activity, at any intensity level, and avoidance of sedentary time are associated with reduced cardiovascular disease risk in older people. Higher time spent in light physical activity and lower sedentary time are associated with lower all-cause mortality.

Physical Activity Patterns among Individuals with Prediabetes or Type 2 Diabetes across Two Years-A Longitudinal Latent Class Analysis

Background: This study aimed to identify distinct profiles of physical activity (PA) patterns among individuals with prediabetes or type 2 diabetes participating in a two-year PA trial and to investigate predictors of the profiles. Methods: Data (n = 168, collected 2013–2020) from the cohort of a randomized trial aimed at increasing PA in individuals with prediabetes and type 2 diabetes were used. PA and sedentary behaviours were assessed by waist-worn ActiGraph GT1M accelerometers at baseline and at 6, 12, 18 and 24 months. Fifteen PA and sedentary variables were entered into a latent class mixed model for multivariate longitudinal outcomes. Multinominal regression analysis modelled profile membership based on baseline activity level, age, gender, BMI, disease status and group randomisation. Results: Two profiles of PA patterns were identified: “Increased activity” (n = 37, 22%) included participants increasing time in PA and decreasing sedentary time. “No change in activity” (n = 131, 78%) included participants with no or minor changes. “Increased activity” were younger (p = 0.003) and more active at baseline (p = 0.011), compared to “No change in activity”. No other predictor was associated with profile membership. Conclusions: A majority of participants maintained PA and sedentary patterns over two years despite being part of a PA intervention. Individuals improving PA patterns were younger and more active at baseline.