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Is rest-activity rhythm prospectively associated with all-cause mortality in older people regardless of sleep and physical activity level? The ‘Como Vai?’ Cohort study

Author

Listed:
  • Andrea Wendt
  • Renata Moraes Bielemann
  • Fernando C Wehrmeister
  • Luiza I C Ricardo
  • Werner de Andrade Müller
  • Adriana Kramer Fiala Machado
  • Maurício Feijó da Cruz
  • Andréa D Bertoldi
  • Soren Brage
  • Ulf Ekelund
  • Luciana Tovo-Rodrigues
  • Inácio Crochemore-Silva

Abstract

Objective: This study aims to test the association of rest-activity rhythm (intradaily variability and interdaily stability) with all-cause mortality in an older adult cohort in Brazil. It also assesses whether the amount of time spent at each intensity level (i.e., physical activity and nocturnal sleep) interferes with this association. Methods: This cohort study started in 2014 with older adults (≥60 years). We investigated deaths from all causes that occurred until April 2017. Rest-activity rhythm variables were obtained using accelerometry at baseline. Intradaily variability indicates higher rhythm fragmentation, while interdaily stability indicates higher rhythm stability. Cox proportional-hazard models were used to test the associations controlling for confounders. Results: Among the 1451 older adults interviewed in 2014, 965 presented valid accelerometry data. During the follow-up period, 80 individuals died. After adjusting the analysis for sociodemographic, smoking, morbidity score, and number of medicines, an increase of one standard deviation in interdaily stability decreased 26% the risk of death. The adjustment for total sleep time and inactivity did not change this association. On the other hand, the association was no longer significant after adjusting for overall physical activity and moderate to vigorous physical activity. Conclusion: Rest-activity rhythm pattern was not associated with mortality when physical activity was considered, possibly because this pattern could be driven by regular exercise. Promoting physical activity remains a relevant strategy to improve population health.

Suggested Citation

  • Andrea Wendt & Renata Moraes Bielemann & Fernando C Wehrmeister & Luiza I C Ricardo & Werner de Andrade Müller & Adriana Kramer Fiala Machado & Maurício Feijó da Cruz & Andréa D Bertoldi & Soren Brage, 2024. "Is rest-activity rhythm prospectively associated with all-cause mortality in older people regardless of sleep and physical activity level? The ‘Como Vai?’ Cohort study," PLOS ONE, Public Library of Science, vol. 19(2), pages 1-13, February.
  • Handle: RePEc:plo:pone00:0298031
    DOI: 10.1371/journal.pone.0298031
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    References listed on IDEAS

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    1. David E. Bloom & Dara Lee Luca, 2016. "The Global Demography of Aging: Facts, Explanations, Future," PGDA Working Papers 13016, Program on the Global Demography of Aging.
    2. Samuel E. Jones & Vincent T. Hees & Diego R. Mazzotti & Pedro Marques-Vidal & Séverine Sabia & Ashley Spek & Hassan S. Dashti & Jorgen Engmann & Desana Kocevska & Jessica Tyrrell & Robin N. Beaumont &, 2019. "Genetic studies of accelerometer-based sleep measures yield new insights into human sleep behaviour," Nature Communications, Nature, vol. 10(1), pages 1-12, December.
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