Standing time with and without ambulation and mortality over 6 years of follow-up: the WHI OPACH Study
Oral Presentation C13.4
Keywords:Epidemiology, Sedentary Behaviour, Physical Activity, Accelerometry, Machine Learning
Background: Previous studies have shown that self-reported time spent standing is associated with reduced risk of mortality. No previous studies have examined this association using objectively measured standing. Purpose: To study the longitudinal relationship between objectively measured standing with and without ambulation and all-cause mortality among older women. Methods: This was a prospective cohort study of 5,878 older (median age=80 years), racially diverse, community-dwelling women in the Objective Physical Activity and Cardiovascular Health Study. This study used a valid machine learning algorithm to categorize up to 7 days of ActiGraph GT3X+ accelerometer data into time spent standing with and without ambulation. (1) Multivariable Cox proportional hazards models estimated mortality risk overall and effect modification by age, BMI, MVPA, sedentary time, physical functioning, and race-ethnicity. Results: There were 691 deaths in 26,649 person-years of follow-up through March 31, 2018. In fully adjusted models, mortality risk was lower among those with more standing (quartile (Q) 4 vs. Q1 HR=0.63; 95% CI=0.49-0.81, p-trend=0.003) and more standing with ambulation (Q4 vs. Q1 HR=0.50; 95% CI=0.35-0.71, p-trend<0.001). Associations of standing with ambulation and mortality were also stronger only among women with above-median sedentary time (HR=0.51; 95% CI=0.38-0.68) compared to women with below-median sedentary time (HR=0.80; 95% CI=0.59-1.07; p-interaction=0.02). Conclusions: Our results suggest that greater time spent standing with or without ambulation is associated with lower risk of mortality among older women. Older women can be encouraged to increase their movement at this end of spectrum. Standing, specifically for older adults, is a safe and feasible behavior that can contribute to a healthy lifestyle and should be promoted as an exercise target. Funding: This work was supported by The National Heart, Lung, and Blood Institute provided funding for the OPACH study (grant number RO1 HL105065 to AZL). Funding also came from training grants provided by the National Institutes of Health (grant numbers T32HL079891-11 and TL1TR001443 to JB). The Women’s Health Initiative program was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, US Department of Health and Human Services (contract numbers HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C).
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Copyright (c) 2021 Purva Jain, John Bellettiere, Nicole Glass, Michael J. LaMonte, Chongzi Di, Andrea Z. LaCroix
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