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. 2017 Feb;12(2):197-200.
doi: 10.1177/1747493016676614. Epub 2016 Oct 26.

Physical inactivity is a strong risk factor for stroke in the oldest old: Findings from a multi-ethnic population (the Northern Manhattan Study)

Joshua Z Willey  1 , Yeseon P Moon  1 , Ralph L Sacco  2 , Heather Greenlee  3 , Keith M Diaz  4 , Clinton B Wright  2 , Mitchell Sv Elkind  1   3 , Yuen K Cheung  5
Affiliations

Physical inactivity is a strong risk factor for stroke in the oldest old: Findings from a multi-ethnic population (the Northern Manhattan Study)

Joshua Z Willey et al. Int J Stroke. 2017 Feb.

Abstract

Background The fastest growing segment of the population is those age ≥80 who have the highest stroke incidence. Risk factor management is complicated by polypharmacy-related adverse events. Aims To characterize the impact of physical inactivity for stroke by age in a multi-ethnic prospective cohort study (NOMAS, n = 3298). Methods Leisure time physical activity was assessed by a validated questionnaire and our primary exposure was physical inactivity (PI). Participants were followed annually for incident stroke. We fit Cox-proportional hazard models to calculate hazard ratios and 95% confidence intervals (HR 95% CI) for the association of PI and other risk factors with risk of stroke including two-way interaction terms between the primary exposures and age (<80 vs. ≥80). Results The mean age was 69 ± 10.3 years and 562 (17%) were ≥80 at enrolment. PI was common in the cohort (40.8%). Over a median of 14 years, we found 391 strokes. We found a significant interaction of age ≥80 on the risk of stroke with PI ( p = 0.03). In stratified models, PI versus any activity (adjusted HR 1.60, 95%CI 1.05-2.42) was associated with an increased risk of stroke among those ≥80. Conclusion Physical inactivity is a treatable risk factor for stroke among those older than age 80. Improving activity may reduce the risk of stroke in this segment of the population.

Keywords: Stroke; aging; epidemiology; exercise; mortality; physical inactivity.

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Conflict of interest statement

Disclosures: The authors report no conflicts of interest. The first author had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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