Association of accelerometer-derived step volume and intensity with hospitalizations and mortality in older adults: A prospective cohort study |
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| Institution: | 1. GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo 45071, Spain;2. CIBER of Frailty and Healthy Aging (CIBERFES), Madrid 28029, Spain;3. Motivation and Behaviour Research Program, Institute for Positive Psychology and Education, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW 2060, Australia;4. Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo 0806, Norway;5. Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo 0473, Norway;6. Geriatric Department, Hospital Virgen del Valle, Toledo 45071, Spain;7. Geriatric Department, Hospital Universitario de Getafe, Getafe 28905, Spain |
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| Abstract: | PurposeThis study aimed to examine the associations of accelerometer-derived steps volume and intensity with hospitalizations and all-cause mortality in older adults.MethodsThis prospective cohort study involved 768 community-dwelling Spanish older adults (78.8 ± 4.9 years, mean ± SD; 53.9% females) from the Toledo Study for Healthy Aging (2012–2017). The number of steps per day and step cadence (steps/min) were derived from a hip-mounted accelerometer worn for at least 4 days at baseline. Participants were followed-up over a mean period of 3.1 years for hospitalization and 5.7 years for all-cause mortality. Cox proportional hazards regression models were used to estimate the individual and joint associations between daily steps and stepping intensity with hospitalizations and all-cause mortality.ResultsIncluded participants walked 5835 ± 3445 steps/day with an intensity of 7.3 ± 4.1 steps/min. After adjusting for age, sex, body mass index (BMI), education, income, marital status and comorbidities, higher step count (hazard ratio (HR) = 0.95, 95% confidence interval (95%CI: 0.90–1.00, and HR = 0.87, 95%CI: 0.81–0.95 per additional 1000 steps) and higher step intensity (HR = 0.95, 95%CI: 0.91–0.99, and HR = 0.89, 95%CI: 0.84–0.95 per each additional step/min) were associated with fewer hospitalizations and all-cause mortality risk, respectively. Compared to the group having low step volume and intensity, individuals in the group having high step volume and intensity had a lower risk of hospitalization (HR = 0.72, 95%CI: 0.52–0.98) and all-cause mortality (HR = 0.60, 95%CI: 0.37–0.98).ConclusionAmong older adults, both high step volume and step intensity were significantly associated with lower hospitalization and all-cause mortality risk. Increasing step volume and intensity may benefit older people. |
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