Association of Accelerometer‐Derived Physical Activity with Incident Cardiovascular Diseases and Mortality in People With Severe Mental Illness

BACKGROUND: Cardiovascular vascular disease (CVD) is a leading cause of increased mortality in people with severe mental illness (SMI). This study aims to examine the dose-response and intensity-specific associations between physical activity (PA) and CVD risk and mortality in people with SMI. METHODS: This prospective cohort study was conducted on 6313 participants with SMI with accelerometry data from UK Biobank from February 2013 to November 2021. Moderate-to-vigorous PA (MVPA) was categorized into 2 groups (<150 and ≥150 min/week) according to the PA guidelines for adults recommended by the World Health Organization, while total PA and light-intensity PA were grouped by tertiles. Incident CVD, all-cause and CVD mortality ascertained by hospital and death registries were primary outcomes. RESULTS: Among 6313 participants (mean age 61.05 years; 33.9% men), 868 developed incident CVD, 233 died from any cause, and 88 died from CVD during a median follow-up of 7 years. PA was inversely associated with the risk of incident CVD, all-cause mortality, and CVD mortality. Performing guideline-recommended MVPA was associated with 18% reduced risk for incident CVD (95% CI, 0.68-0.99), 42% for all-cause mortality (95% CI, 0.43-0.79), and 49% for CVD mortality (95% CI, 0.31-0.83). A combination of recommended MVPA and moderate light-intensity PA was associated with the lowest risk, with risk reductions of 24%, 59%, and 78%, respectively. CONCLUSIONS: Adequate PA, especially guideline-recommended MVPA, was associated with a lower risk for incident CVD, all-cause and CVD mortality among SMI population. Combining recommended MVPA with moderate light-intensity PA yielded extra benefits.