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. 2022 Apr 1;77(4):842-850.
doi: 10.1093/gerona/glac023.

Objectively Measured Total Sedentary Time and Pattern of Sedentary Accumulation in Older Adults: Associations With Incident Cardiovascular Disease and All-Cause Mortality

Manasa Shanta Yerramalla  1 , Vincent T van Hees  2 , Mathilde Chen  1 , Aurore Fayosse  1 , Sebastien F M Chastin  3   4 , Séverine Sabia  1   5
Affiliations

Objectively Measured Total Sedentary Time and Pattern of Sedentary Accumulation in Older Adults: Associations With Incident Cardiovascular Disease and All-Cause Mortality

Manasa Shanta Yerramalla et al. J Gerontol A Biol Sci Med Sci. .

Abstract

Background: We examined associations of total duration and pattern of accumulation of objectively measured sedentary behavior (SB) with incident cardiovascular disease (CVD) and all-cause mortality among older adults.

Methods: Total sedentary time and 8 sedentary accumulation pattern metrics were extracted from accelerometer data of 3 991 Whitehall II study participants aged 60-83 years in 2012-2013. Incident CVD and all-cause mortality were ascertained up to March 2019.

Results: Two hundred and ninety-nine CVD cases and 260 deaths were recorded over a mean (standard deviation [SD]) follow-up of 6.2 (1.3) and 6.4 (0.8) years, respectively. Adjusting for sociodemographic and behavioral factors, 1-SD (100.2 minutes) increase in total sedentary time was associated with 20% higher CVD risk (hazard ratio [95% confidence interval]: 1.20 [1.05-1.37]). More fragmented SB was associated with reduced CVD risk (eg, 0.86 [0.76-0.97] for 1-SD [6.2] increase in breaks per sedentary hour). Associations were not evident once health-related factors and moderate-to-vigorous physical activity (MVPA) were considered. For all-cause mortality, associations with more fragmented SB (eg, 0.73 [0.59-0.91] for breaks per sedentary hour) were found only among the youngest older group (<74 years; p for interaction with age < .01) independently from all covariates.

Conclusions: In this study, no associations of total sedentary time and sedentary accumulation patterns with incident CVD and all-cause mortality were found in the total sample once MVPA was considered. Our findings of reduced mortality risk with less total and more fragmented SB independent from MVPA among individuals <74 years need to be replicated to support the recent recommendations to reduce and fragment SB.

Keywords: Accelerometer; Breaks in sedentary behavior; Moderate-to-vigorous physical activity; Prospective.

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Figures

Figure 1.
Figure 1.
Description of metrics of sedentary accumulation pattern. Notes: LIPA = light intensity physical activity; MVPA = moderate-to-vigorous physical activity; SB = sedentary behavior.
Figure 2.
Figure 2.
Associations of total sedentary time and sedentary accumulation patterns with all-cause mortality stratified by age. Notes: CI = confidence interval; LIPA = light intensity physical activity; MVPA = moderate-to-vigorous physical activity. Models adjusted for age (as timescale), sociodemographic, behavioral, health-related risk factors, and MVPA recommendation. Metrics are standardized based on sample mean and SD resulting in HRs corresponding to 1-SD higher value. For metrics 1–3, an increase of 1 SD corresponds to less favorable sedentary accumulation pattern. For metrics 4–8, an increase of 1 SD corresponds to more favorable sedentary accumulation pattern. 1 SD represents 100.2 minutes for total sedentary time, 6.1 minutes for mean sedentary bout duration, 143.2 minutes for time in prolonged (≥30 minutes) sedentary bouts, 0.036 for Gini index, 16.0 for number of sedentary breaks, 6.2 for breaks per sedentary hour, 0.127 for Alpha, and 3.1% and 0.5% for transition probability from sedentary to LIPA and MVPA states, respectively.
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