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THE ASSOCIATION OF PHYSICAL ACTIVITY FRAGMENTATION WITH ALL-CAUSE MORTALITY IN HISPANICS: A PROSPECTIVE COHORT STUDY
Author
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Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doença de Chagas. Rio de Janeiro, RJ, Brasil / National Institute of Cardiology. Department of Research and Education. Rio de Janeiro, RJ, Brazil / Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / New York University Grossman School of Medicine. Optimal Aging Institute. New York, NY, USA.
University of North Carolina at Chapel Hill. Department of Biostatistics. Chapel Hill, NC, USA.
University of North Carolina at Chapel Hill. Department of Biostatistics. Chapel Hill, NC, USA.
Albert Einstein College of Medicine. Department of Epidemiology and Population Health. Bronx, NY, USA.
Albert Einstein College of Medicine. Department of Epidemiology and Population Health. Bronx, NY, USA / Fred Hutch Cancer Center. Public Health Sciences Division. Seattle, WA, USA.
Center for Children's Healthy Lifestyles & Nutrition. Children's Mercy Kansas City. Kansas City, MO, USA.
Fred Hutch Cancer Center. Public Health Sciences Division. Seattle, WA, USA.
Institute for Minority Health Research. University of Illinois at Chicago. College of Medicine. Chicago, IL, USA.
Institute for Minority Health Research. University of Illinois at Chicago. College of Medicine. Chicago, IL, USA.
University of North Carolina. Gillings School of Global Public Health. Department of Epidemiology. Chapel Hill, NC, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA / New York University Grossman School of Medicine. Optimal Aging Institute. New York, NY, USA.
University of North Carolina at Chapel Hill. Department of Biostatistics. Chapel Hill, NC, USA.
University of North Carolina at Chapel Hill. Department of Biostatistics. Chapel Hill, NC, USA.
Albert Einstein College of Medicine. Department of Epidemiology and Population Health. Bronx, NY, USA.
Albert Einstein College of Medicine. Department of Epidemiology and Population Health. Bronx, NY, USA / Fred Hutch Cancer Center. Public Health Sciences Division. Seattle, WA, USA.
Center for Children's Healthy Lifestyles & Nutrition. Children's Mercy Kansas City. Kansas City, MO, USA.
Fred Hutch Cancer Center. Public Health Sciences Division. Seattle, WA, USA.
Institute for Minority Health Research. University of Illinois at Chicago. College of Medicine. Chicago, IL, USA.
Institute for Minority Health Research. University of Illinois at Chicago. College of Medicine. Chicago, IL, USA.
University of North Carolina. Gillings School of Global Public Health. Department of Epidemiology. Chapel Hill, NC, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA.
Johns Hopkins Bloomberg School of Public Health. Department of Epidemiology. Baltimore, MD, USA.
Abstract
Background: Physical activity fragmentation represents the frequency of transitioning from an active to sedentary state. The prognostic information of physical activity fragmentation is unclear in Hispanics/Latinos. This study examined the association of PA fragmentation with all-cause mortality in Hispanic/Latino adults. Methods: We investigated 11,992 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) (18-74 yr; 52.2% women), from four United States urban communities (Bronx, New York; Chicago, Illinois; Miami, Florida; San Diego, California), that wore an accelerometer for one week. Physical activity fragmentation was calculated using the active-to-sedentary transition probability (ASTP) as the reciprocal of the average active bout duration. Daily total log-transformed activity count (TLAC) was used as a measure of total physical activity. The residual of ASTP regressed on TLAC (TLAC-adjusted ASTP) was explored to investigate the association of ASTP independent of total physical activity. Deaths were identified from annual follow-up interviews, obituary searches, or matches to the National Death Index through December 31, 2021. Cox regression models were fitted according to physical activity fragmentation. Findings: There were 745 deaths (6.2%) over a mean follow-up of 11.2 (SD 2.2) years. The highest compared to the lowest tertile of ASTP showed a HR of 1.45 (95% CI 1.10-1.92) of all-cause mortality after accounting for confounders. The mortality risk also increased for each 0.10-unit increase of ASTP, as a continuous variable, by 22% (HR 1.22; 95% CI 1.07-1.39). The results were similar considering TLAC-adjusted ASTP. Interpretation: Among Hispanic/Latino adults, more fragmented physical activity was associated with elevated all-cause mortality, independent of total physical activity volume.
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