Protective association of higher frequency physical exercise with all-cause mortality risk in stroke patients: evidence from the health and retirement study

IF 2.1 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2026-03-01 Epub Date: 2026-01-18 DOI:10.1016/j.jstrokecerebrovasdis.2026.108563

Jingtao Du , Xiaofeng Jiang , Binghua Shao , Liu Zhenshun , Liu Tianyu , Jianwei Wu

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引用次数: 0

Abstract

Objective

To examine the association between the different exercise frequency in daily life and all-cause mortality risk of the patients after stroke, and to analyze their dose-response relationship.

Methods

1,639 participants with stroke were selected from Health and Retirement Study (HRS) database. Based on physical exercise frequency questionnaires, participants were categorized into five groups: sedentary (n=152), low (n=276), moderate (n=212), high (n=205), and vigorous (n=794). Multivariate Cox proportional hazards regression models and survival analyses were applied to examine the associations between exercise frequency and all-cause mortality risk in stroke patients.

Results

Median follow-up time revealed that both median survival time and interquartile range increased progressively with higher exercise frequency. Multivariate Cox regression analysis demonstrated a significant dose-response relationship: Compared to the sedentary group, moderate, high, and vigorous exercise groups exhibited significantly reduced death risks of 28%, 35%, and 42%, respectively. Exercise score showed a significant negative correlation with mortality rate (r=-0.855). Kaplan-Meier survival analysis revealed significant divergence in survival curves among different exercise frequency groups (log-rank P<0.001), with the vigorous exercise group demonstrating the highest cumulative survival rate. Age-stratified analysis indicated that patients aged ≤65 years had the most favorable survival prognosis, while survival rates significantly decreased with advancing age (log-rank P< 0.001).

Conclusion

Higher frequency physical exercise manifested a protective association with reduced all-cause mortality risk in stroke patients, with a clear dose-response relationship. These findings support incorporating regular moderate-to-high-frequency exercise into daily life to reduce the hazards of stroke and improve long-term prognosis.

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高频率体育锻炼与卒中患者全因死亡风险的保护性关联：来自健康与退休研究的证据

目的：探讨日常生活中不同运动频率与脑卒中患者全因死亡风险的关系，并分析两者的量效关系。方法：从健康与退休研究（HRS）数据库中选取1639例脑卒中患者。根据体育锻炼频率问卷，参与者被分为五组：久坐（n=152），低（n=276），中等（n=212），高（n=205）和剧烈（n=794）。应用多变量Cox比例风险回归模型和生存分析来检验卒中患者运动频率与全因死亡风险之间的关系。结果：中位随访时间显示，随着运动频率的增加，中位生存时间和四分位间距逐渐增加。多变量Cox回归分析显示了显著的剂量-反应关系：与久坐组相比，中度、高强度和剧烈运动组的死亡风险分别显著降低了28%、35%和42%。运动评分与死亡率呈显著负相关（r=-0.855）。Kaplan-Meier生存分析显示，不同运动频率组的生存曲线存在显著差异（log-rank P < 0.001），剧烈运动组的累积生存率最高。年龄分层分析显示，年龄≤65岁的患者生存预后最有利，随着年龄的增长，生存率显著降低（log-rank P < 0.001）。结论：高频率的体育锻炼与降低脑卒中患者全因死亡风险具有保护作用，且存在明显的剂量-反应关系。这些发现支持在日常生活中加入定期的中高频率运动，以减少中风的危险，改善长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.