Meeting 24-Hour Movement Guidelines and Mortality Risk in Older Adults: Cross-Sectional and Longitudinal Pooled Analysis in the Seniors-ENRICA Cohorts

BACKGROUND: We assessed the association of adherence to the guidelines and subsequent changes over time in adherence with all-cause mortality. METHODS: We used data from 3 518 and 3 273 older adults, aged 60-96 years at baseline, from Seniors-ENRICA 1 and 2 cohorts, respectively. Adherence to 24-hour movement guidelines was defined as ≥150 min/wk of moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB) ≤8 h/d (including ≤3 h/d of recreational screen time), and 7-9 h/d of sleep if aged 18-64 years or 7-8 h/d if aged ≥65 years. All-cause mortality was ascertained up to January 31, 2024. Analyses were performed using Cox regression adjusted for the main confounders. RESULTS: Of the 6 613 participants with complete data, 1 353 died during a mean follow-up of 10.1 (standard deviation [SD] = 4.0) years. Meeting MVPA (hazard ratio [HR] 0.73; 95% confidence interval [CI] 0.65-0.82), SB (HR 0.89; 95% CI 0.80-0.99), and sleep (HR 0.89; 95% CI 0.80-0.99) recommendations were associated with lower mortality. Also, we noticed a reduction in mortality in meeting MVPA combined with both SB (34%) and sleep (12%), sleep and SB combined (23%), and meeting all 24-hour movement guidelines (40%). Changes in meeting 24-hour movement guidelines occurred between a mean follow-up of 2.8 (0.6) years. Meeting 24-hour movement guidelines at baseline and follow-up is associated with lower mortality (HR 0.69; 95% CI 0.47-0.99), compared to not meet them at both examinations. CONCLUSIONS: This prospective cohort study underscores the critical impact of adhering to and maintaining adherence to the 24-hour movement guidelines in reducing mortality risk among older adults.