Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?

Jefferis, Barbara J; Parsons, Tessa J; Sartini, Claudio; Ash, Sarah; Lennon, Lucy T; Papacosta, Olia; Morris, Richard W; Wannamethee, S Goya; Lee, I-Min; Whincup, Peter H

doi:10.1136/bjsports-2017-098733

Cited by 244Physical Activity and HealthContext-Aware Activity Recognition SystemsHealth disparities and outcomes

Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?

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Jefferis, Barbara J, Parsons, Tessa J, Sartini, Claudio, Ash, Sarah, Lennon, Lucy T, Papacosta, Olia, Morris, Richard W, Wannamethee, S Goya +2 more·2019·British Journal of Sports Medicine

DOI 10.1136/bjsports-2017-098733PMC PMC6691867

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Abstract

Objectives: To understand how device-measured sedentary behaviour and physical activity are related to all-cause mortality in older men, an age group with high levels of inactivity and sedentary behaviour. Methods: Prospective population-based cohort study of men recruited from 24 UK General Practices in 1978–1980. In 2010–2012, 3137 surviving men were invited to a follow-up, 1655 (aged 71–92 years) agreed. Nurses measured height and weight, men completed health and demographic questionnaires and wore an ActiGraph GT3x accelerometer. All-cause mortality was collected through National Health Service central registers up to 1 June 2016. Results: After median 5.0 years’ follow-up, 194 deaths occurred in 1181 men without pre-existing cardiovascular disease. For each additional 30 min in sedentary behaviour, or light physical activity (LIPA), or 10 min in moderate to vigorous physical activity (MVPA), HRs for mortality were 1.17 (95% CI 1.10 to 1.25), 0.83 (95% CI 0.77 to 0.90) and 0.90 (95% CI 0.84 to 0.96), respectively. Adjustments for confounders did not meaningfully change estimates. Only LIPA remained significant on mutual adjustment for all intensities. The HR for accumulating 150 min MVPA/week in sporadic minutes (achieved by 66% of men) was 0.59 (95% CI 0.43 to 0.81) and 0.58 (95% CI 0.33 to 1.00) for accumulating 150 min MVPA/week in bouts lasting ≥10 min (achieved by 16% of men). Sedentary breaks were not associated with mortality. Conclusions: In older men, all activities (of light intensity upwards) were beneficial and accumulation of activity in bouts ≥10 min did not appear important beyond total volume of activity. Findings can inform physical activity guidelines for older adults.

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Dwyer et al. and Jefferis et al. both found an association between all-cause mortality and step count where every increment of 1000 steps per day led to a 6 and 14% risk reduction, respectively.
“Here, Dwyer et al. and Jefferis et al. both found an association between all-cause mortality and step count where every increment of 1000 steps per day led to a 6 and 14% risk reduction, respectively [68, 69].”
From Can consumer wearable activity tracker-based interventions improve physical activity and cardiometabolic health in patients with chronic diseases? A systematic review and meta-analysis of randomised controlled trials (2020) · cites this paper as [69]

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Physical activity trajectories, mortality, hospitalization, and disability in the Toledo Study of Healthy Aging
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Dose–Response Association Between Accelerometer-Assessed Physical Activity and Incidence of Functional Disability in Older Japanese Adults: A 6-Year Prospective Study
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Physical Activity Intensity Cut-Points for Wrist-Worn GENEActiv in Older Adults
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Low gait speed is associated with low physical activity and high sedentary time following stroke
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The U-Shaped Relationship Between Levels of Bouted Activity and Fall Incidence in Community-Dwelling Older Adults: A Prospective Cohort Study
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Effect of a Home-Based Mobile Health App Intervention on Physical Activity Levels in Patients With Heart Failure
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A Positive Psychology–Motivational Interviewing Intervention to Promote Positive Affect and Physical Activity in Type 2 Diabetes: The BEHOLD-8 Controlled Clinical Trial
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Using Devices to Assess Physical Activity and Sedentary Behavior in a Large Cohort Study: The Women’s Health Study
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Associations of neighborhood walkability with intensity‐ and bout‐specific physical activity and sedentary behavior of older adults in Japan
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Daily steps and diet, but not sleep, are related to mortality in older Australians
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A 2-Year Longitudinal Study of Physical Activity and Cardiovascular Risk in Survivors of Stroke
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Green Walkability and Physical Activity in UK Biobank: A Cross-Sectional Analysis of Adults in Greater London
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Patterns and Correlates of Sedentary Behaviour Accumulation and Physical Activity in People with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study
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activPAL and ActiGraph Assessed Sedentary Behavior and Cardiometabolic Health Markers
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Exploring Perceived Barriers to Physical Activity among Older Adults Living in Low-Population Density Regions: Gender Differences and Associations with Activity Dimensions
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Examining How Dog ‘Acquisition’ Affects Physical Activity and Psychosocial Well-Being: Findings from the BuddyStudy Pilot Trial
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Association Between 20-Year Trajectories of Nonoccupational Physical Activity From Midlife to Old Age and Biomarkers of Cardiovascular Disease: A 20-Year Longitudinal Study of British Men
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Recomendaciones de actividad física: un mensaje para el profesional de la salud
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Are Exercise Referral Schemes Associated With an Increase in Physical Activity? Observational Findings Using Individual Patient Data Meta-Analysis From the National Referral Database
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Sammut, M., Fini, N. A., Haracz, K., Nilsson, M., English, C., & Janssen, H. (2020) · Disability and Rehabilitation · doi:10.1080/09638288.2020.1768599 · Cited by 18 · see citing works
Leisure-Time Physical Activity and Cancer Risk Among Older Adults: A Cohort Study
Cohen, G., Steinberg, D. M., Keinan‐Boker, L., Shaked, O., Goshen, A., Shimony, T., Shohat, T., & Gerber, Y. (2020) · Mayo Clinic Proceedings Innovations Quality & Outcomes · doi:10.1016/j.mayocpiqo.2019.11.005 · Cited by 16 · see citing works

Associations of objectively measured physical activity and sedentary time with all-cause mortality in Japanese older adults: a 10-year prospective study
Chen, T., Chen, S., Honda, T., Kishimoto, H., Nofuji, Y., & Narazaki, K. (2025) · British Journal of Sports Medicine · doi:10.1136/bjsports-2024-108258 · Cited by 10 · see citing works
Objective Measures of Activity Level and Mortality in Older Men
Ensrud, K. E., Blackwell, T., Cauley, J. A., Dam, T.-T. L., Cawthon, P. M., Schousboe, J. T., Barrett-Connor, E. L., Stone, K. L., Bauer, D. C., Shikany, J. M., et al. (2014) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13101 · Cited by 77 · see citing works
OP83 #Is volume of physical activity more important than pattern of accumulation for onset of cardiovascular disease? a prospective study of objectively measured physical activity intensities and sedentary behaviour in older men
Jefferis, B. J. M. H., Parsons, T. J., Sartini, C., Ash, S., LENNON, L. T., Papacosta, O., Wannamethee, S. G., Lee, I.-M. M., & Whincup, P. H. (2018) · Oral Presentations · doi:10.1136/jech-2018-ssmabstracts.82
Self-citation
Joint associations of accelerometer-measured physical activity and sedentary time with all-cause mortality: a harmonised meta-analysis in more than 44 000 middle-aged and older individuals
Ekelund, U., Tarp, J., Fagerland, M. W., Johannessen, J. S., Hansen, B. H., Jefferis, B. J. M. H., Whincup, P. H., Diaz, K. M., Hooker, S. P., Howard, V. J., et al. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-103270 · Cited by 367 · see citing works
Self-citation
Does total volume of physical activity matter more than pattern for onset of CVD? A prospective cohort study of older British men
Jefferis, B. J., Parsons, T. J., Sartini, C., Ash, S., Lennon, L. T., Papacosta, O., Morris, R. W., Wannamethee, S. G., Lee, I.-M., & Whincup, P. H. (2019) · International Journal of Cardiology · doi:10.1016/j.ijcard.2018.12.024 · Cited by 65 · see citing works
Self-citation

Authors: Jefferis, B. J., Parsons, T. J., Sartini, C., Ash, S., Lennon, L. T., Papacosta, O., Morris, R. W., Wannamethee, S. G., Lee, I.-M., & Whincup, P. H.
Affiliations: University College London (GB)
University of Bristol (GB)
Brigham and Women's Hospital (US)
St George's, University of London (GB)
Corresponding author: Jefferis, Barbara J
ORCID: Jefferis, Barbara J
Parsons, Tessa J
Sartini, Claudio
Ash, Sarah
Lennon, Lucy T
Papacosta, Olia
Morris, Richard W
Wannamethee, S Goya
Lee, I-Min
Whincup, Peter H
Venue: British Journal of Sports Medicine
Publisher: BMJ
Published: 2018-02-12
Volume: 53
Issue: 16
Pages: 1013-1020
ISSN: 0306-3674 (ISSN-L)
1473-0480
DOI: 10.1136/bjsports-2017-098733
PMC: PMC6691867
OpenAlex: W2788594244
Cited by: 244
References: 36
Citations by year: 2026: 9 · 2025: 14 · 2024: 24 · 2023: 35 · 2022: 31 · 2021: 30 · 2020: 58 · 2019: 30 · 2018: 13
FWCI: 22.52
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
Locations: British Journal of Sports Medicine (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Bristol Research (University of Bristol) (publishedVersion, cc-by)
St George's Online Research Archive (St George's University of London) (acceptedVersion)
UCL Discovery (University College London) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: British Heart Foundation
Research Trainees Coordinating Centre
Topics: Health Sciences › Medicine › Physiology › Physical Activity and Health
Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
Social Sciences › Health › Health disparities and outcomes
Keywords: physical activity, sedentary behavior, all-cause mortality, older men, light physical activity, moderate-to-vigorous physical activity, bout duration, sedentary breaks, accelerometer-measured activity, physical activity guidelines
MeSH terms: Aged, Aged, 80 and over, Follow-Up Studies, Heart Rate, Humans, Male, Mortality, Prospective Studies, Surveys and Questionnaires, Exercise, Body Mass Index, Actigraphy, Sedentary Behavior

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Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?

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