Associations Of Steps Per Day And Step Intensity With Mortality: Findings From HCHS/SOL

PURPOSE: Greater steps per day (steps/day) have been associated with a lower risk of mortality, but less is known about this relationship among Hispanic/Latino adults in the United States (US). We examined the associations of steps/day and step intensity with the risk of all-cause mortality and how these associations varied by age (<60 years, >60 years) among 11,871 adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a cohort of adults from four US metropolitan cities. METHODS: Steps/day and step intensity (peak 30-min cadence, minutes spent at >40 steps/min, a stepping rate corresponding to purposeful steps or faster movement) were collected with accelerometry at baseline (2008-2011) and mortality was ascertained through 2017. Cox proportional hazards models were used to estimate associations of step metrics with the risk of mortality as hazard ratios (HR) and 95% confidence intervals (CIs). Models were adjusted for demographics, health behaviors, and health conditions and accounted for the HCHS/SOL complex survey design. RESULTS: The average age at baseline was 41 years, 52% were female, 38% were of Mexican heritage, and 51% were employed. On average, adults wore the accelerometer for 16 hours/day, accumulated 7,918 steps/day, had a peak 30-min cadence of 75 steps/min, and spent 64 minutes at >40 steps/min cadence. Among adults <60 years (n = 9,700) there were 180 deaths (1.6%) and among adults >60 years (n = 2,171) there were 164 deaths (9.4%) over an average of 7.8 years of follow-up. Per 1,000 steps/day, adults >60 years had an 8% lower risk of death (HR = 0.92 (95% CI: 0.86, 0.98)) while the HR for adults <60 years was 0.99 (95% CI: 0.94, 1.04). There were nonsignificant inverse associations per 10 step/min increases of peak 30-min cadence and min at >40 steps/min among adults >60 years (peak 30-min HR = 0.89 (95% CI:0.79, 1.01), min >40 steps/min HR = 0.93 (95% CI: 0.87, 1.00). The HRs per 10 step/min increases for peak 30-min cadence and min at >40 steps/min were 0.99 (95% CI 0.89, 1.11) and 1.00 (95% CI 0.96, 1.04) among adults <60 years. CONCLUSIONS: Among Hispanic/Latino adults from four metropolitan areas in the US, there were small inverse associations of steps/day with the risk of all-cause mortality among adults 60 years and older. Kelly Evenson, Daniela Sotres-Alvarez, and Yasmin Mossavar-Rahmani were supported by grant #R01HL136266 from the National Heart, Lung, and Blood Institute (NHLBI).