Meeting 24-hour movement guidelines and mortality risk in older adults: cross-sectional and longitudinal pooled analysis in the Seniors-ENRICA cohorts.

Background: We assessed the association of adherence to the guidelines and subsequent changes over time in adherence with all-cause mortality.

Methods: We used data from 3518 and 3273 older adults, aged 60-96 years at baseline, from Seniors-ENRICA-1 and 2 cohorts, respectively. Adherence to 24-hour movement guidelines was defined as ≥150 minutes/week of moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB) ≤8 hours/day (including ≤3 hours/day of recreational screen time), and 7-9 hours/day of sleep if aged 18-64y or 7-8 hours/day if aged ≥65y. All-cause mortality was ascertained up to January 31, 2024. Analyses were performed using Cox regression adjusted for the main confounders.

Results: Of the 6613 participants with complete data, 1353 died during a mean follow-up of 10.1 (SD = 4.0) years. Meeting MVPA (hazard ratio [HR] 0.73; 95% confidence interval [CI] 0.65-0.82), SB (HR 0.89; 95% CI 0.80-0.99), and sleep (HR 0.89; 95% CI 0.80-0.99) recommendations were associated with lower mortality. Also, we noticed a reduction in mortality in meeting MVPA combined with both SB (34%) and sleep (12%), sleep and SB combined (23%), and meeting all 24-hour movement guidelines (40%). Changes in meeting 24-hour movement guidelines occurred between a mean follow-up of 2.8 (0.6) years. Meeting 24-hour movement guidelines at baseline and follow-up is associated with lower mortality (HR 0.69; 95% CI 0.47-0.99), compared to not meet them at both examinations.

Conclusions: This prospective cohort study underscores the critical impact of adhering to and maintaining adherence to the 24-hour movement guidelines in reducing mortality risk among older adults.