Objectively Measured Daily Steps and Subsequent Long Term All-Cause Mortality: The Tasped Prospective Cohort Study

Abstract

BackgroundSelf–reported physical activity has been inversely associated with mortality but the effect of objectively measured step activity on mortality has never been evaluated. The objective is to determine the prospective association of daily step activity on mortality among free-living adults.Methods and FindingsCohort study of free-living adults residing in Tasmania, Australia between 2000 and 2005 who participated in one of three cohort studies (n = 2 576 total participants). Daily step activity by pedometer at baseline at a mean of 58.8 years of age, and for a subset, repeated monitoring was available 3.7 (SD 1.3) years later (n = 1 679). All-cause mortality (n = 219 deaths) was ascertained by record-linkage to the Australian National Death Index; 90% of participants were followed-up over ten years, until June 2011. Higher daily step count at baseline was linearly associated with lower all-cause mortality (adjusted hazard ratio AHR, 0.94; 95% CI, 0.90 to 0.98 per 1 000 steps; P = 0.004). Risk was altered little by removing deaths occurring in the first two years. Increasing baseline daily steps from sedentary to 10 000 steps a day was associated with a 46% (95% CI, 18% to 65%; P = 0.004) lower risk of mortality in the decade of follow-up. In addition, those who increased their daily steps over the monitoring period had a substantial reduction in mortality risk, after adjusting for baseline daily step count (AHR, 0.39; 95% CI, 0.22 to 0.72; P = 0.002), or other factors (AHR, 0.38; 95% CI, 0.21–0.70; P = 0.002).ConclusionsHigher daily step count was linearly associated with subsequent long term mortality among free living adults. These data are the first to quantify mortality reductions using an objective measure of physical activity in a free living population. They strongly underscore the importance of physical inactivity as a major public health problem.

Effect of a Primary Care Walking Intervention with and without Nurse Support on Physical Activity Levels in 45- to 75-Year-Olds: The Pedometer And Consultation Evaluation (PACE-UP) Cluster Randomised Clinical Trial

“…Based on a systematic review, which has quantified the strength of association between PA (particularly walking) and developing coronary heart disease [39], the increase of 33 min/wk in the postal group in our study at 12 mo, if sustained, would be expected to reduce coronary heart disease risk by 4.5% (95% CI 3%, 6%; see S3 Text for details). Similarly, a cohort study relating pedometer-measured steps to mortality [40] allowed us to estimate that a sustained increase of 642 steps/day would be expected to decrease all-cause mortality by 4% (95% CI 1%, 7%).…”

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

“…4 Recently, prospective cohort studies using bodyworn devices to measure PA report that more time spent in MVPA is associated with lower mortality risks and sedentary behaviour with higher risks. [17][18][19][20][21][22][23][24][25][26][27] However, few address the question of pattern of accumulation of activity rather than total volume. Most of the studies use the US National Health and Nutrition Examination Survey (NHANES) data set, [17][18][19][20][21][22][23] and not all findings are consistent.…”

Impact of Hemodialysis and Post-Dialysis Period on Granular Activity Levels

“…[45] General and elderly populations have been shown to exhibit an inverse relationship between steps taken and outcomes. [46][47][48][49][50] Achievement of increases of 1000 more steps per day associates with about a 5% lower cardiovascular event rate and a 15% lower all-cause mortality rate. [46,47] A 7-year observational study in HD patients found taking ≥5000 steps a day associates with an 18.5 percentage point improvement in the cumulative survival rate compared to having <5000 steps daily.…”