Associations between device-measured physical activity patterns and 8-year incidence of cardiovascular events in well-functioning older adults: variations by age

BACKGROUND: Moderate-to-vigorous physical activity (MVPA) protects against cardiovascular disease (CVD) but less is known about how different physical activity (PA) patterns influence CVD risk. This study examined these associations considering age-related differences. METHODS: Data from 423 CVD-free participants from the Swedish SNAC-K study were analyzed. Accelerometer data was collected from 2016 to 2019 and CVD events (fatal and non-fatal) over an 8-year period were obtained from national registers. Cox regression models were employed to assess associations between PA patterns-including steps per day, sit-to-stand transitions, daily time in light PA (LPA) and MVPA, and walking events (i.e. daily number of LPA or MVPA walking bouts)-and CVD risk. Cubic splines evaluated non-linear relationships, and interactions between PA and age-group (=66 vs. ≥80 years) were explored. RESULTS: Over a mean follow-up period of 5.6 years, 125 participants (30%) experienced at least one CVD event. In the total sample, each additional 10 MVPA walking events reduced CVD risk (HR 0.90, 95% CI 0.82-0.98, p=0.019). Among the oldest-old, each additional 100 LPA walking events (HR 0.61, 95% CI 0.39-0.95, p=0.027) and each additional 10 MVPA walking events (HR 0.87, 95% CI 0.76-0.98, p=0.024) reduced CVD risk. No clear associations were observed in younger-old adults. CONCLUSIONS: In this cohort of generally well-functioning older adults, frequent daily engagement in MVPA was associated with a reduced risk of incident CVD. Among the oldest-old, recurrent participation in both LPA and MVPA was linked to lower CVD risk, highlighting the importance of frequent daily PA.