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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 CMAJ 2017 ; 189 (33): E1056-64 Nephropedia Template TP
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Association between sedentary time and mortality across levels of frailty #MMPMID28827436
Theou O; Blodgett JM; Godin J; Rockwood K
CMAJ 2017[Aug]; 189 (33): E1056-64 PMID28827436show ga
BACKGROUND:: Sedentary behaviours are associated with adverse health outcomes in middle-aged and older adults, even among those who exercise. We examined whether the degree of frailty affects the association between sedentary behaviours and higher risk of mortality. METHODS:: In this prospective cohort study, we used data from 3141 community-dwelling adults 50 years of age or older from the 2003/04 and 2005/06 cohorts of the US National Health and Nutrition Examination Survey. Time engaged in sedentary behaviours was measured using uniaxial accelerometers, and frailty was based on a 46-item frailty index. Mortality data were linked up to 2011. We used Cox proportional hazard models to estimate the hazard ratio (HR) of sedentary behaviour. RESULTS:: We found that for people with low levels of frailty (frailty index score ? 0.1), sedentary time was not predictive of mortality, regardless of physical activity level (adjusted HR 0.90, 95% confidence interval [CI] 0.70?1.15). Among people who were vulnerable (0.1 < frailty index score ? 0.2) or frail (frailty index score > 0.2), sedentary time was associated with higher mortality only among those who were physically inactive (not meeting the criterion for moderate physical activity) (HR 1.16, 95% CI 1.02?1.33 for the group defined by 0.1 < frailty index score ? 0.2; HR 1.27, 95% CI 1.11?1.46 for the group defined by 0.2 < frailty index score ? 0.3; HR 1.34, 95% CI 1.19?1.50 for frailty index score > 0.3). INTERPRETATION:: The effect of sedentary behaviours on mortality varied by level of frailty. Adults with the highest frailty level experienced the greatest adverse impact. Low frailty levels (frailty index score ? 0.1) seemed to eliminate the increased risk of mortality associated with prolonged sitting, even among people who did not meet recommended physical activity guidelines.