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. 2017 Feb;32(2):168-174.
doi: 10.1007/s11606-016-3884-y. Epub 2016 Oct 17.

Leisure-Time Physical Activity and Cardiovascular Mortality in an Elderly Population in Northern Manhattan: A Prospective Cohort Study

Ying Kuen Cheung  1 , Yeseon P Moon  2 , Erin R Kulick  2 , Ralph L Sacco  3 , Mitchell S V Elkind  2   4 , Joshua Z Willey  5
Affiliations

Leisure-Time Physical Activity and Cardiovascular Mortality in an Elderly Population in Northern Manhattan: A Prospective Cohort Study

Ying Kuen Cheung et al. J Gen Intern Med. 2017 Feb.

Abstract

Background: Previous studies of exercise have focused on measuring physical activity in totality using summary statistics such as metabolic equivalent score for total intensity or total energy count.

Objective: We aimed to examine the multidimensionality of leisure-time physical activity (LTPA) and to identify the specific LTPA components that were associated with cardiovascular mortality in the elderly.

Design and participants: The Northern Manhattan Study (NOMAS) is a multiethnic prospective cohort of elderly stroke-free individuals consisting of a total of 3298 participants recruited between 1993 and 2001, with a median follow-up of 17 years.

Main measures: Physical activity questionnaire data were available in 3293 NOMAS participants, who were categorized into subgroups with similar exercise patterns by model-based cluster analysis. Three subgroup-defining LTPA features were identified and were considered as primary exposures in Cox proportional hazard models: frequency of activity, number of activity types (variety), and energy-to-duration ratio (EDR). We considered cardiovascular mortality and non-cardiovascular mortality as outcomes in Cox cause-specific proportional hazard models, and all-cause mortality as outcome in Cox models.

Key results: A high activity frequency was associated with reduced cardiovascular mortality (hazard ratio, HR = 0.93, P = 0.03), but demonstrated no effect on non-cardiovascular death. A high EDR was associated with increased risk of cardiovascular death (HR = 1.30, P = 0.01). A high number of activity types was beneficial in reducing all-cause mortality (HR = 0.87, P = 0.01).

Conclusions: Exercise frequency was protective against cardiovascular mortality, and a high variety of activity was protective against all-cause mortality. The performance of frequent and varied non-intense exercise in an elderly population such as ours is achievable and can reduce the risk of death.

Keywords: cardiovascular; exercise; mortality.

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Conflict of interest statement

The authors declare that they have no conflict of interest. Funding/Support This study was supported by the National Institutes of Health grants R01 HL111195 (Cheung/Elkind), NS K23073104 (Willey), and R01 NS029993 (Sacco/Elkind). Role of the Funder/Sponsor The funding source had no role in the design and conduct of the study with regard to the collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Figures

Fig. 1
Fig. 1
Characteristics of leisure-time physical activity in NOMAS participants. The numbers indicate the subgroups to which participants belong. Participants in subgroup 1 reported no physical activity, i.e., having all physical activity measures equal to 0. (These plots use data from 1546 random samples of the 3021 subjects, because the plots using all subjects were too large to transmit).
Fig. 2
Fig. 2
Assessment of non-linear effects of physical activity on cardiovascular death. The P values indicate a test of non-linearity based on chi-square tests with approximately three degrees of freedom. The dotted yellow lines indicate one standard error from the fitted spline.
See this image and copyright information in PMC

Comment in

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