Instrumented measures of sedentary behaviour and physical activity are associated with mortality in community-dwelling older adults: A systematic review, meta-analysis and meta-regression analysis

Anna G M Rojer; Keenan A Ramsey; Marijke C Trappenburg; Natascha M van Rijssen; René H J Otten; Martijn W Heymans; Mirjam Pijnappels; Carel G M Meskers; Andrea B Maier

doi:10.1016/j.arr.2020.101061

Instrumented measures of sedentary behaviour and physical activity are associated with mortality in community-dwelling older adults: A systematic review, meta-analysis and meta-regression analysis

Ageing Res Rev. 2020 Aug:61:101061. doi: 10.1016/j.arr.2020.101061. Epub 2020 Apr 30.

Authors

Anna G M Rojer¹, Keenan A Ramsey¹, Marijke C Trappenburg², Natascha M van Rijssen³, René H J Otten⁴, Martijn W Heymans⁵, Mirjam Pijnappels¹, Carel G M Meskers⁶, Andrea B Maier⁷

Affiliations

¹ Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
² Department of Internal Medicine, Amstelland Hospital, Laan van de Helende Meesters 8, 1186 AM, Amstelveen, The Netherlands; Department of Internal Medicine, Amsterdam University Medical Center, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
³ Department of Internal Medicine, Section Nutritional Sciences and Dietetics, Department of Endocrinology and Metabolism, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
⁴ Medical Library, Vrije Universiteit Amsterdam, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
⁵ Department of Epidemiology and Biostatistics Amsterdam University Medical Center, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
⁶ Department of Rehabilitation Medicine, Amsterdam University Medical Center, VU University Medical Center, Amsterdam Movement Sciences, de Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.
⁷ Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands; Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, 300 Grattan Street, Parkville, Victoria 3050, Melbourne, Australia. Electronic address: a.b.maier@vu.nl.

PMID: 32360669
DOI: 10.1016/j.arr.2020.101061

Abstract

Background: Sedentary behaviour (SB) and physical activity (PA) can be objectively assessed with inertial sensors to describe bodily movement. Higher SB and lower PA is associated with higher chronological age and negative health outcomes. This study aimed to quantify the association between instrumented measures of SB (i-SB) and PA (i-PA) and mortality in community-dwelling older adults, to subsequently compare the quantitative effect sizes and to determine the dose-response relationships.

Methods: An electronic search in six databases from inception to 27th of June 2019 was conducted. All articles reporting on i-SB or i-PA and mortality in community-dwelling older adults aged 60 years or older were considered eligible. A meta-analysis was conducted for the association between i-SB and i-PA and mortality expressed in Hazard Ratios (HR) and 95% Confidence Intervals (95% CI). A meta-regression analysis was performed to determine the dose-response relationship between i-SB and steps per day and mortality.

Results: Twelve prospective articles representing eleven cohorts, reporting data of 38,141 participants were included. In total 2502 (6.4%) participants died during follow-up (2.0 to 9.8 years). Comparing the most sedentary with the least sedentary groups of participants resulted in a pooled HR of 2.44 (95% CI 1.82-3.25). Comparing the least active with the most active groups of participants resulted in a pooled HR of 1.93 (95% CI 1.39-2.69); 2.66 (95% CI 2.11-3.35); 3.43 (95% CI 2.61-4.52), and 3.09 (95% CI 2.33-4.11) for light, moderate-to-vigorous-, total PA and steps per day, respectively. Meta-regression analyses showed clear dose-response relationships between i-SB and steps per day and mortality risk.

Conclusion: Both i-SB and i-PA are significantly associated with mortality in community-dwelling older adults, showing the largest effect size for total physical activity. Dose-response relationships could be observed for i-SB and steps per day.

Keywords: Accelerometry; Aged; Ambulatory mobility assessment; Mortality; Motor activity; Sedentary behaviour.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Aged
Aging / physiology
Exercise / physiology*
Humans
Independent Living*
Mortality*
Prospective Studies
Regression Analysis
Sedentary Behavior*