Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Internal Medicine, 184(7), 718. https://doi.org/10.1001/jamainternmed.2024.0892 Dr. Rikuta Hamaya et al.
Points
- A study of 14,399 women aged 62 and older investigated the impact of moderate to vigorous physical activity (MVPA) time and step counts on all-cause mortality and cardiovascular disease (CVD) risks.
- MVPA time and step counts similarly reduce risks of all-cause mortality and CVD, with hazard ratios of 0.82 for MVPA time and 0.74 for step counts.
- Participants in higher quartiles for MVPA time and step counts had extended life expectancy by over two months compared to those in the lowest quartile.
- The area under the curve (AUC) values for predicting all-cause mortality were modest and similar for MVPA time and step counts at 0.55.
- The study supports including step count goals in physical activity guidelines, offering flexibility and potential for more personalized and effective interventions for older women.
Summary
In a comprehensive cohort study of 14,399 women, researchers explored the effectiveness of using moderate to vigorous physical activity (MVPA) time and step counts to reduce all-cause mortality and cardiovascular disease (CVD) risks among women aged 62 and older. This analysis utilized data from an ongoing follow-up to the Women’s Health Study, initially a randomized clinical trial evaluating the effects of low-dose aspirin and vitamin E from 1992 to 2004. At the outset, participants, free from CVD and cancer, tracked their physical activity using an accelerometer during a 2011-2015 ancillary study, with follow-ups extending through December 2022.
The study findings revealed that MVPA time and daily step counts were similarly effective in associating with lower risks of all-cause mortality and CVD. Specifically, for each standard deviation increase, the hazard ratios (HR) for all-cause mortality were 0.82 (95% CI, 0.75-0.90) for MVPA time and 0.74 (95% CI, 0.69-0.80) for step counts. Furthermore, participants in the top three quartiles for MVPA time and step counts, compared to those in the lowest quartile, experienced an extended period free from death by 2.22 (95% CI, 1.58-2.85) months and 2.36 (95% CI, 1.73-2.99) months, respectively, over a 9-year follow-up. The area under the curve (AUC) values for predicting all-cause mortality were similarly modest for both measures at 0.55 (95% CI, 0.52-0.57).
These results support the inclusion of step count-based goals alongside traditional time-based recommendations in future physical activity guidelines for older women. The findings indicate that both metrics are similarly effective in enhancing longevity and reducing CVD risk, allowing for flexibility in how individuals meet their physical activity goals based on personal preference and lifestyle. This could lead to more tailored and, thus, more effective interventions in population health management.
Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2818632
References Hamaya, R., Shiroma, E. J., Moore, C. C., Buring, J. E., Evenson, K. R., & Lee, I.-M. (2024). Time- vs Step-Based Physical Activity Metrics for Health. JAMA Internal Medicine, 184(7), 718. https://doi.org/10.1001/jamainternmed.2024.0892
