Weekend Warrior Physical Activity, Sedentary Behavior, and Incident Disability in Middle‐Aged and Older Adults: A UK Biobank Accelerometer Study

AIM: Regular moderate-to-vigorous physical activity (MVPA) is associated with lower risks of functional decline and disability. Whether concentrating MVPA into 1 or 2 days per week-the "weekend warrior" pattern-is associated with disability risk similarly to regularly distributed activity remains unclear, particularly among individuals with high sedentary behavior. METHODS: We analyzed wrist-worn accelerometer data from 41 225 UK Biobank participants without identifiable baseline disability based on available indicators (mean age 61.6 years; 60.3% women). Participants were classified as inactive (< 150 min/week), weekend warriors (≥ 150 min/week with ≥ 50% accumulated in 1-2 days), or regularly active (≥ 150 min/week but not weekend warriors). Disability was assessed once during follow-up and defined as a self-reported need for assistance with at least one of six activities of daily living because of a health condition. Associations with incident disability were estimated using Cox proportional hazards models for interval-censored outcomes, adjusting for sociodemographic characteristics, lifestyle factors, and baseline health status. RESULTS: During a median follow-up of 7.7 years, 2589 participants were classified as having disability at follow-up. Compared with inactive individuals, weekend warrior and regularly active patterns were associated with similarly lower disability risk (weekend warrior: HR 0.68, 95% CI 0.61-0.75; regularly active: HR 0.66, 95% CI 0.60-0.73). These associations were observed across sedentary behavior levels. CONCLUSIONS: Accumulating recommended MVPA within 1 or 2 days per week was associated with disability risk reductions comparable to regularly distributed activity. Flexible activity patterns may help support functional independence and healthy aging.