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Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?
  1. Barbara J Jefferis1,
  2. Tessa J Parsons1,
  3. Claudio Sartini1,
  4. Sarah Ash1,
  5. Lucy T Lennon1,
  6. Olia Papacosta1,
  7. Richard W Morris2,
  8. S Goya Wannamethee1,
  9. I-Min Lee3,
  10. Peter H Whincup4
  1. 1 Department of Primary Care and Population Health, University College London, London, UK
  2. 2 Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
  3. 3 Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts, USA
  4. 4 Population Health Research Institute, St George’s University of London, London, UK
  1. Correspondence to Dr Barbara J Jefferis, Department of Primary Care and Population Health, University College London, London NW3 2PF, UK; b.jefferis{at}


Objectives To understand how device-measured sedentary behaviour and physical activity are related to all-cause mortality in older men, an age group with high levels of inactivity and sedentary behaviour.

Methods Prospective population-based cohort study of men recruited from 24 UK General Practices in 1978–1980. In 2010–2012, 3137 surviving men were invited to a follow-up, 1655 (aged 71–92 years) agreed. Nurses measured height and weight, men completed health and demographic questionnaires and wore an ActiGraph GT3x accelerometer. All-cause mortality was collected through National Health Service central registers up to 1 June 2016.

Results After median 5.0 years’ follow-up, 194 deaths occurred in 1181 men without pre-existing cardiovascular disease. For each additional 30 min in sedentary behaviour, or light physical activity (LIPA), or 10 min in moderate to vigorous physical activity (MVPA), HRs for mortality were 1.17 (95% CI 1.10 to 1.25), 0.83 (95% CI 0.77 to 0.90) and 0.90 (95% CI 0.84 to 0.96), respectively. Adjustments for confounders did not meaningfully change estimates. Only LIPA remained significant on mutual adjustment for all intensities. The HR for accumulating 150 min MVPA/week in sporadic minutes (achieved by 66% of men) was 0.59 (95% CI 0.43 to 0.81) and 0.58 (95% CI 0.33 to 1.00) for accumulating 150 min MVPA/week in bouts lasting ≥10 min (achieved by 16% of men). Sedentary breaks were not associated with mortality.

Conclusions In older men, all activities (of light intensity upwards) were beneficial and accumulation of activity in bouts ≥10 min did not appear important beyond total volume of activity. Findings can inform physical activity guidelines for older adults.

  • physical activity
  • sedentary behaviour
  • accelerometer
  • mortality
  • bouts.

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  • Contributors BJJ designed the analytical strategy, conducted statistical analyses and the literature review, and drafted the manuscript and tables. BJJ is the guarantor. TJP conducted initial statistical analyses and tables. CS processed the accelerometer data and contributed to statistical analyses and producing figures. SA implemented the physical activity field study, including quality assurance and control. LTL implemented the physical activity field study and coordinated the collection of mortality data including quality assurance and control. OP created the questionnaire and mortality databases, linked the data and checked the data for quality. RWM contributed to the overall running of the study and provided statistical input. SGW is a director of the study and oversaw the fieldwork and data collection, and contributed to the interpretation and discussion of results. IML contributed to the analysis plan, and the interpretation and discussion of the results. PHW is a director of the study, led the introduction of objective PA assessment in BRHS and oversaw the fieldwork and data collection, and contributed to the interpretation and discussion of results. All authors contributed to drafting the work or revising it critically for important intellectual content and approved the version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This work was supported by the British Heart Foundation (PG/13/86/30546 and RG/13/16/30528) and the National Institute of Health Research (Post-Doctoral Fellowship 2010-03-023). The funders had no role in the design and conduct of the study; collection, management, analysis, interpretation of the data; preparation, review, approval of or decision to publish the manuscript.

  • Disclaimer The views expressed in this publication are those of the author(s) and not necessarily those of the funders. All authors had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

  • Competing interests None declared.

  • Ethics approval The National Research Ethics Service Committee London.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are not publicly available, but applications for data sharing can be made. For enquiries, please contact LTL (

  • Correction notice This article has been corrected since it was published Online First. The in-text citations (references) have been corrected.