Abstract
Objective: The aim of this study was to examine the independent and combined associations of physical activity (PA) and sitting time (ST) with long-term mortality attributed to inflammatory causes other than cardiovascular disease (CVD) and cancer in a national cohort of older adults in Spain.Design: Prospective study.Setting and Participants: A cohort of 3,677 individuals (1,626 men) aged ≥60 years was followed-up during 14.3 years.Measures: At baseline, individuals reported PA and ST. The study outcome was death from inflammatory diseases when CVD or cancer mortality was excluded. This outcome was classified into infectious and non-infectious conditions. Analyses were performed with Cox regression and adjusted for PA, ST, and other main confounders (age, sex, educational level, smoking, alcohol consumption, body mass index, and chronic conditions).Results: During follow-up, 286 deaths from inflammatory diseases (77 from infectious diseases) were identified. Compared to individuals who defined themselves as inactive/less active, mortality from inflammatory diseases was lower in those who were moderately active (hazard ratio [HR] = 0.67, 95% confidence interval [CI] = 0.50–0.90) or very active (HR = 0.48, 95%CI = 0.33–0.68), independently of ST. Also, being seated ≥7 h/d vs. <7 h/d was linked to higher mortality (HR = 1.38, 95%CI = 1.02–1.87). The largest risk of mortality was observed in inactive/less active individuals with ST≥7 h/d (HR = 2.29, 95%CI = 1.59–3.29) compared to those with moderate/very PA and ST <7 h/d. Low PA and high ST were consistently associated with a higher risk of mortality from non-infectious inflammatory causes. Associations of PA and ST with mortality from infectious inflammatory causes showed a similar trend, but most of them did not reach statistical significance.Conclusions: Low PA and high ST were independently associated with higher mortality from inflammatory diseases other than CVD or cancer in older adults. Interventions addressing simultaneously both behaviors could have greater benefits than those focusing on only one of them.
Highlights
Inflammation is a physiological response to tissue injuries or infections (Addison et al, 2012)
The effect of physical activity (PA) and sitting time (ST) on cardiovascular disease (CVD) and cancer mortality has been widely studied in adults (Nocon et al, 2008; Katzmarzyk et al, 2009; Wilmot et al, 2012), no previous investigation has focused on mortality from other diseases with a major inflammatory component in older adults
To examine the combined effect of PA and ST on inflammatory mortality, first, we considered as health risk behaviors (HRBs) the categories of PA and ST (≥7 h/d) showing a detrimental role on inflammatory mortality in the aforementioned individual associations
Summary
Inflammation is a physiological response to tissue injuries or infections (Addison et al, 2012). When inflammation persists, chronically elevated systemic levels of pro-inflammatory cytokines can lead an increased risk of inflammatory diseases. In this sense, chronic inflammation is known to play a central role in the etiology of cardiovascular disease (CVD) and cancer (Singh-Manoux et al, 2017) and plays a major pathogenic role in other diseases such as diabetes, chronic kidney disease, inflammatory bowel, cirrhosis, chronic obstructive pulmonary disease, rheumatoid arthritis, and several neurodegenerative conditions (Dungey et al, 2013; Holmes, 2013; Wang et al, 2013). This work examined the independent and combined association of PA and ST with longterm mortality from inflammatory diseases, after excluding CVD or cancer mortality, in a national cohort of older adults
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