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Relationship between Subdomains of Total Physical Activity and Mortality

BESSON, HERVÉ1,2; EKELUND, ULF1; BRAGE, SØREN1; LUBEN, ROBERT3; BINGHAM, SHEILA4; KHAW, KAY-TEE3; WAREHAM, NICHOLAS J.1

Medicine & Science in Sports & Exercise: November 2008 - Volume 40 - Issue 11 - pp 1909-1915
doi: 10.1249/MSS.0b013e318180bcad
BASIC SCIENCES: Epidemiology

Purpose: The purpose of this study was to describe the association of the overall and domain-specific physical activity on all-cause and cardiovascular mortality. A large body of epidemiological evidence suggests a strong and consistent inverse association between physical activity and mortality risk. However, it is unclear how this association varies according to the domain of life in which the activity takes place.

Methods: In an English population-based cohort of 14,903 participants (mean age = 63 yr), total and domain-specific physical activity was assessed using a validated questionnaire (EPAQ2). After a median follow-up of 7 yr, there were 1128 deaths, with 370 from cardiovascular disease.

Results: The relative risks (95% confidence interval) for all-cause mortality due to physical activity undertaken at home, during exercise, at work, for transport, and in total were 0.81 (0.66-0.99), 0.66 (0.54-0.80), 0.84 (0.55-1.30), 0.82 (0.67-1.00), and 0.77 (0.61-0.98), respectively, after adjustment for baseline age, sex, social class, alcohol consumption, smoking status, history of diabetes, history of cancer, and history of cardiovascular disease and stroke. Cardiovascular mortality was inversely associated with physical activity undertaken at home (P for trend = 0.03), during exercise (P for trend = 0.001), and in total (P for trend = 0.007). The results were unchanged after excluding individuals with a history of heart disease, stroke, and cancer at baseline and those who died within the first 2 yr of follow-up.

Conclusions: In this study, physical activities at home and during exercise are associated with lower risk of mortality, whereas occupational and transportation-related activities are not. Promoting the potential benefits of physical activity undertaken at home and during exercise may be an important public health message for aging populations.

1Epidemiology Unit, Medical Research Council, Cambridge, UNITED KINGDOM; 2Julius Center for Health Sciences and Primary Care, Utrecht, THE NETHERLANDS; 3Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UNITED KINGDOM; and 4Dunn Nutrition Unit, Medical Research Council, Cambridge, UNITED KINGDOM

Address for correspondence: Hervé Besson, Ph.D., MRC Epidemiology Unit, Institute of Metabolic Science, Box 285 Addenbrooke's Hospital Hills Rd, Cambridge, CB2 0QQ, United Kingdom; E-mail: herve.besson@mrc-epid.cam.ac.uk or hbesson@umcutrecht.nl.

Submitted for publication February 2008.

Accepted for publication May 2008.

©2008The American College of Sports Medicine