Association between adherence to the 24-hour movement guidelines and the prevalence and mortality of osteoarthritis: A population-based study

The health effects of integrated 24-hour movement guidelines (including moderate-to-vigorous physical activity, sedentary behavior, and sleep time) on osteoarthritis (OA) remain poorly understood. We examined the associations between adherence to 24-hour movement guidelines and OA prevalence and subsequent mortality. We analyzed data from 34,051 adults participating in National Health and Nutrition Examination Surveys (1999-2018). Osteoarthritis prevalence was evaluated using multivariable logistic regression. For survival analyses, 3594 participants with OA were linked to the National Death Index through 2019. Cox proportional hazards models were used to estimate adjusted hazard ratio (AHR) for all-cause and cardiovascular disease mortality. Meeting all 3 movement guidelines was associated with a lower prevalence of OA (adjusted odds ratio = 0.80, 95% confidence interval [95% CI]: 0.64-1.00) compared with meeting none. Among individuals with OA, greater adherence to movement guidelines was linked to a stepwise reduction in mortality risk. Participants meeting all 3 guidelines demonstrated the lowest risks of all-cause mortality (AHR = 0.34, 95% CI: 0.23-0.49) and cardiovascular disease mortality (AHR = 0.29, 95% CI: 0.13-0.61). Even partial adherence (meeting 1 or 2 guidelines) was associated with significant survival benefits relative to meeting none. Adherence to 24-hour movement guidelines is associated with lower OA prevalence and markedly reduced mortality risk among affected individuals.