Quantifying the time-varying association between objectively measured physical activity and mortality in US older adults over a 12-year follow-up period: the NHANES 2003-2006 study.

IF 9 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL BMJ Evidence-Based Medicine Pub Date : 2024-11-22 DOI:10.1136/bmjebm-2023-112303
Neha Agarwala, Vadim Zipunnikov, Ciprian Crainiceanu, Andrew Leroux
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Abstract

Objectively measuring physical activity (PA) has consistently shown an association with reduced all-cause mortality risk in cross-sectional studies. However, the strength of this association may change over time. We quantify the time-varying, covariate-adjusted association between the total volume of PA and all-cause mortality over a 12-year follow-up period using Cox regression with a time varying effect of population-referenced quantile total activity count adjusted for traditional risk factors. Analyses focus on participants 50-84 years old with adequate accelerometer wear time and without missing covariates. The findings suggest that (1) the use of baseline PA in Cox models with long follow-up periods may be inappropriate without time-varying effects and (2) the use of accelerometry derived volume of PA in risk score calculations may be most appropriate for short-term to medium-term risk scores.

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量化美国老年人在 12 年随访期内客观测量的体力活动与死亡率之间的时变关系:NHANES 2003-2006 年研究。
在横断面研究中,对体力活动(PA)进行客观测量的结果显示,体力活动与降低全因死亡风险有关联。然而,这种关联的强度可能会随着时间的推移而改变。我们采用 Cox 回归方法量化了随时间变化的、经协变量调整的体育锻炼总量与 12 年随访期内全因死亡率之间的关系,并对传统风险因素进行了调整。分析主要针对年龄在 50-84 岁、有足够加速度计佩戴时间且没有缺失协变量的参与者。研究结果表明:(1) 在没有时变效应的情况下,在长时间随访的 Cox 模型中使用基线活动量可能并不合适;(2) 在计算风险评分时使用加速度计得出的活动量可能最适合短期到中期的风险评分。
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来源期刊
BMJ Evidence-Based Medicine
BMJ Evidence-Based Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
8.90
自引率
3.40%
发文量
48
期刊介绍: BMJ Evidence-Based Medicine (BMJ EBM) publishes original evidence-based research, insights and opinions on what matters for health care. We focus on the tools, methods, and concepts that are basic and central to practising evidence-based medicine and deliver relevant, trustworthy and impactful evidence. BMJ EBM is a Plan S compliant Transformative Journal and adheres to the highest possible industry standards for editorial policies and publication ethics.
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