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. 2024 Oct 1;56(10):1926-1934.
doi: 10.1249/MSS.0000000000003497. Epub 2024 Jul 1.

NHANES 2011-2014: Objective Physical Activity Is the Strongest Predictor of All-Cause Mortality

Andrew Leroux  1 , Erjia Cui, Ekaterina Smirnova  2 , John Muschelli  3 , Jennifer A Schrack  4 , Ciprian M Crainiceanu  3
Affiliations

NHANES 2011-2014: Objective Physical Activity Is the Strongest Predictor of All-Cause Mortality

Andrew Leroux et al. Med Sci Sports Exerc. .

Abstract

Introduction: Objectively measured physical activity (PA) is a modifiable risk factor for mortality. Understanding the predictive performance of PA is essential to establish potential targets for early intervention to reduce mortality among older adults.

Methods: The study used a subset of the National Health and Nutrition Examination Survey (NHANES) 2011-2014 data consisting of participants 50 to 80 yr old ( n = 3653, 24297.5 person-years of follow-up, 416 deaths). Eight accelerometry-derived features and 14 traditional predictors of all-cause mortality were compared and ranked in terms of their individual and combined predictive performance using the 10-fold cross-validated concordance (C) from Cox regression.

Results: The top 3 predictors of mortality in univariate analysis were PA related: average Monitor-Independent Movement Summary (MIMS) in the 10 most active hours (C = 0.697), total MIMS per day (C = 0.686), and average log-transformed MIMS in the most 10 active hours of the day (C = 0.684), outperforming age (C = 0.676) and other traditional predictors of mortality. In multivariate regression, adding objectively measured PA to the top performing model without PA variables increased concordance from C = 0.776 to C = 0.790 ( P < 0.001).

Conclusions: These findings highlight the importance of PA as a risk marker of mortality and are consistent with prior studies, confirming the importance of accelerometer-derived activity measures beyond total volume.

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