Infrequent Activity Suggests Poor Health Outcomes

The study, published in October 2019 in JAMA Network Open, utilized activity information gathered from 548 participants’ wearable monitors. Participants were well-functioning older adults enrolled in the National Institute on Aging’s Baltimore Longitudinal Study of Aging. Researchers found that over the 10-year study period within the group, there was no connection between overall daily activity levels and increased mortality risk. However, an association between mortality risk and more fragmented physical activity was found.

“Fragmentation of physical activity may be an early indicator of increasing mortality risk,” said study lead author Amal Wanigatunga, PhD, an assistant scientist in the Johns Hopkins Bloomberg School’s Department of Epidemiology. “By examining these patterns of routine activity and the decline in patterns of fragmented activity, we can begin to identify trajectories toward premature serious illness and death sooner and work to develop interventions and preventive strategies to reverse it.”

Among the fastest growing segments of the U.S. population, adults aged 65 and older are increasingly sedentary. Previous studies have shown that less physical activity among older adults is a predictor of more illness and premature death. However, more recently Wanigatunga, along with study senior author Jennifer Schrack, PhD, associate professor in the Department of Epidemiology at the Bloomberg School, and their colleagues, have begun to explore activity fragmentation as a potentially more sensitive marker of overall health and functioning among older adults.

Of the 548 participants studied, 487 were alive at the end of the study in 2017, and 61 had died. The living participants engaged in an average of 5.7 total hours of activity per day, compared with 4.7 total hours for those who later died. But after accounting for variable factors such as age, gender, race, body mass index, and existing illnesses, Wanigatunga and colleagues found that total physical activity overall was too weakly associated with mortality risk to reach statistical significance. But that was not the case for activity fragmentation. Researchers found that for each 10% higher activity fragmentation, there was a 49% increase in the risk of mortality. Activity fragmentation was defined as the probability of transitioning from an active state to a sedentary state for each participant, so shorter average activity periods meant higher fragmentation.

Researchers also analyzed the duration of each participant’s periods of activity and found that the percentage of activity spent in sessions of less than five minutes seemed to be a good indicator of mortality risk. Each additional 10% of activity time spent in such short sessions was associated with a 28% increase in the risk of mortality. On the other hand, the percentage of active time spent in bouts longer than 10 minutes—such as deliberate physical exercise— unsurprisingly showed a trend toward being a marker of reduced mortality risk.

Wanigatunga noted that the participants studied had an average age of 76 but were, on the whole, healthier than the general population of older adults in the United States. Additionally, he suggested that although time spent exercising, such as brisk walking, is often examined as a marker for mortality risk, most physical activity for older adults comes from ordinary lighter-intensity activity performed routinely throughout the day, such as doing laundry, preparing meals, gardening, and even getting the mail.

Scheduling physical activity is a lifestyle choice that can pay dividends in maintaining good health. If you’re planning to launch a dedicated exercise program, confer with your provider to plan a safe and effective physical activity regimen, along with a healthy eating plan. As noted by the National Institutes of Health, physical activity is a protective factor for noncommunicable diseases such as cardiovascular disease, stroke, diabetes, and some types of cancer and is associated with improved mental health and delay in the onset of dementia. 



Ithaca Primary Care

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