Association Between Physical Activity, Sedentary Behavior And Risk Of All-cause And Cardiovascular Disease Mortality Among People With Arthritis: The National Health And Nutrition Examination Survey (nhanes) 2007-2016

Arthritis is an inflammatory disease associated with increased risk of mortality. Physical activity (PA) can be beneficial in management of the disease, and thereby reducing the risk of morbidities and mortality among people with arthritis. Purpose: To examine the association between moderate to vigorous physical activity (MVPA) and sedentary behavior with risk of all-cause and cardiovascular mortality in a nationally representative U.S. sample of individuals with Arthritis. Methods: We included 7166 participants aged 40 years or older from the NHANES conducted from 2007 to 2016. Participants were prospectively followed up for mortality through 2019, using death certificate records. Participants reported arthritis diagnosis. PA and sedentary behavior were measured using the Global Physical Activity Questionnaire. MVPA (minutes per week) was categorized into 4 groups based on PA guidelines and sedentary behavior (minutes per day) was categorized into 4 groups of 4 hour increments. We used weighted multivariate Cox regression models adjusted for age, gender, race, education, smoking, hypertension, cholesterol, diabetes, and cardiovascular diseases. Sedentary behavior and MVPA were mutually adjusted. Results: The mean follow up was 7.1 ± 0.1 person-years. There were 1666 all-cause and 441 cardiovascular related deaths. Compared to the participants who reported no MVPA, all three active groups had lower risk of all-cause mortality (~50%) Compared the least sedentary group (0-240 minutes/day), those who spent more than 480+ minutes per day in sedentary behavior had 69% higher risk of all-cause mortality. There were similar associations for cardiovascular mortality. Conclusion: Participating in any amount of MVPA and avoiding high levels (≥8 hours/day) of sedentary behavior were independently associated with lower risk of mortality among people with arthritis. Moving more and sitting less is important for longevity benefits among people with arthritis.