Table 2.
Associations of accelerometer measures of physical activity and sitting with incident mild cognitive impairment and probable dementia among older women in the Objective Physical Activity and Cardiovascular Health (OPACH) study 2012–2020.
| Moderate-to-vigorous intensity physical activity (minutes/day) | |||||||
|---|---|---|---|---|---|---|---|
| Q1 (<23) | Q2 (23–39) | Q3 (39–61) | Q4 (≥61) | HR for 1-SD increment (31.2) | P-trenda | n | |
| MCI events [rateb] | 45 [36.8] | 52 [42.0] | 44 [31.0] | 26 [18.3] | |||
| Model 1c | 1 (ref) | 1.14 (0.76–1.71) | 0.91 (0.60–1.38) | 0.61 (0.37–1.00) | 0.81 (0.67–0.98) | 0.030 | 1,284 |
| Model 2c | 1 (ref) | 1.24 (0.79–1.95) | 0.92 (0.57–1.50) | 0.60 (0.34–1.07) | 0.79 (0.63–0.98) | 0.033 | 977 |
| Model 2Ac | 1 (ref) | 1.26 (0.80–1.97) | 0.91 (0.56–1.48) | 0.64 (0.36–1.13) | 0.80 (0.64–1.00) | 0.047 | 1,042 |
| Dementia events [rateb] | 45 [33.8] | 54 [39.8] | 36 [23.5] | 26 [17.7] | |||
| Model 1c | 1 (ref) | 1.17 (0.79–1.74) | 0.77 (0.49–1.19) | 0.66 (0.40–1.08) | 0.81 (0.66–0.98) | 0.031 | 1,331 |
| Model 2c | 1 (ref) | 1.30 (0.82–2.05) | 0.91 (0.54–1.51) | 0.83 (0.47–1.45) | 0.88 (0.70–1.10) | 0.251 | 1,014 |
| Model 2Ac | 1 (ref) | 1.21 (0.77–1.90) | 0.84 (0.51–1.40) | 0.79 (0.45–1.37) | 0.86 (0.69–1.08) | 0.189 | 1,082 |
| MCI or dementia events [rateb] | 74 [60.7] | 88 [71.9] | 61 [43.1] | 44 [31.1] | |||
| Model 1c | 1 (ref) | 1.17 (0.86–1.60) | 0.75 (0.53–1.06) | 0.61 (0.41–0.89) | 0.78 (0.67–0.90) | 0.001 | 1,274 |
| Model 2c | 1 (ref) | 1.29 (0.91–1.84) | 0.81 (0.55–1.21) | 0.66 (0.43–1.03) | 0.79 (0.66–0.94) | 0.007 | 967 |
| Model 2Ac | 1 (ref) | 1.28 (0.91–1.81) | 0.79 (0.53–1.17) | 0.69 (0.45–1.06) | 0.79 (0.67–0.94) | 0.009 | 1,032 |
| Light intensity physical activity (minutes/day) | |||||||
| Q1 (<226) | Q2 (226–275) | Q3 (275–323) | Q4 (≥323) | HR for 1-SD increment (70.7) | P-trenda | n | |
| MCI events [rateb] | 31 [24.7] | 49 [35.8] | 40 [29.5] | 47 [35.5] | |||
| Model 1c | 1 (ref) | 1.54 (0.98–2.43) | 1.26 (0.78–2.03) | 1.63 (1.03–2.59) | 1.14 (0.98–1.33) | 0.081 | 1,284 |
| Model 2c | 1 (ref) | 1.57 (0.93–2.63) | 1.44 (0.84–2.48) | 1.83 (1.05–3.21) | 1.18 (0.98–1.43) | 0.086 | 977 |
| Model 2Ac | 1 (ref) | 1.56 (0.93–2.63) | 1.41 (0.82–2.43) | 1.89 (1.08–3.28) | 1.19 (0.99–1.44) | 0.064 | 1,042 |
| Dementia events [rateb] | 37 [27.5] | 44 [29.7] | 46 [31.8] | 34 [24.1] | |||
| Model 1c | 1 (ref) | 1.16 (0.74–1.79) | 1.25 (0.81–1.93) | 0.99 (0.62–1.59) | 0.97 (0.83–1.14) | 0.734 | 1,331 |
| Model 2c | 1 (ref) | 1.15 (0.70–1.89) | 1.42 (0.86–2.33) | 1.11 (0.63–1.95) | 0.99 (0.81–1.21) | 0.941 | 1,014 |
| Model 2Ac | 1 (ref) | 1.10 (0.67–1.79) | 1.28 (0.78–2.10) | 1.08 (0.62–1.87) | 0.97 (0.80–1.17) | 0.730 | 1,082 |
| MCI or dementia events [rateb] | 55 [44.4] | 77 [56.4] | 67 [49.7] | 68 [51.5] | |||
| Model 1c | 1 (ref) | 1.36 (0.96–1.93) | 1.18 (0.82–1.69) | 1.30 (0.91–1.86) | 1.06 (0.94–1.20) | 0.343 | 1,274 |
| Model 2c | 1 (ref) | 1.47 (0.99–2.17) | 1.33 (0.88–2.02) | 1.41 (0.91–2.19) | 1.07 (0.92–1.24) | 0.398 | 967 |
| Model 2Ac | 1 (ref) | 1.40 (0.95–2.06) | 1.25 (0.83–1.88) | 1.42 (0.93–2.18) | 1.07 (0.92–1.23) | 0.403 | 1,032 |
| Steps (n/day) | |||||||
| Q1 (<1,867) | Q2 (1,867–2,809) | Q3 (2,809–4,050) | Q4 (≥4,050) | HR for 1-SD increment (1,865) | P-trenda | n | |
| MCI events [rateb] | 54 [50.4] | 49 [36.0] | 40 [28.1] | 24 [16.6] | |||
| Model 1c | 1 (ref) | 0.72 (0.49–1.06) | 0.60 (0.39–0.91) | 0.39 (0.24–0.64) | 0.74 (0.60–0.90) | 0.003 | 1,284 |
| Model 2c | 1 (ref) | 0.64 (0.40–1.01) | 0.60 (0.37–1.00) | 0.33 (0.18–0.61) | 0.67 (0.51–0.87) | 0.003 | 977 |
| Model 2Ac | 1 (ref) | 0.62 (0.40–0.99) | 0.60 (0.37–0.99) | 0.36 (0.20–0.66) | 0.69 (0.53–0.89) | 0.006 | 1,042 |
| Dementia events [rateb] | 53 [43.6] | 49 [33.4] | 37 [24.5] | 22 [14.8] | |||
| Model 1c | 1 (ref) | 0.81 (0.55–1.19) | 0.63 (0.41–0.96) | 0.42 (0.25–0.70) | 0.70 (0.57–0.87) | 0.001 | 1,331 |
| Model 2c | 1 (ref) | 0.84 (0.53–1.31) | 0.68 (0.41–1.13) | 0.48 (0.26–0.88) | 0.72 (0.56–0.92) | 0.010 | 1,014 |
| Model 2Ac | 1 (ref) | 0.83 (0.53–1.29) | 0.65 (0.39–1.08) | 0.48 (0.26–0.87) | 0.71 (0.55–0.91) | 0.008 | 1,082 |
| MCI or dementia events [rateb] | 84 [79.1] | 81 [59.9] | 65 [46.0] | 37 [25.6] | |||
| Model 1c | 1 (ref) | 0.77 (0.57–1.05) | 0.61 (0.44–0.84) | 0.37 (0.25–0.55) | 0.69 (0.59–0.81) | <0.001 | 1,274 |
| Model 2c | 1 (ref) | 0.75 (0.53–1.08) | 0.66 (0.44–0.98) | 0.35 (0.22–0.58) | 0.65 (0.53–0.81) | <0.001 | 967 |
| Model 2Ac | 1 (ref) | 0.73 (0.51–1.03) | 0.64 (0.43–0.94) | 0.38 (0.23–0.61) | 0.67 (0.54–0.82) | <0.001 | 1,032 |
| Sitting time (minutes/day) | |||||||
| Q1 (<569) | Q2 (569–637) | Q3 (637–704) | Q4 (≥704) | HR for 1-SD increment (97.2) | P-trenda | n | |
| MCI events [rateb] | 41 [31.3] | 38 [27.9] | 44 [33.9] | 34 [29.3] | |||
| Model 1c | 1 (ref) | 0.83 (0.53–1.29) | 0.94 (0.61–1.44) | 0.81 (0.51–1.28) | 0.92 (0.78–1.08) | 0.286 | 1,234 |
| Model 2c | 1 (ref) | 0.73 (0.44–1.20) | 0.83 (0.51–1.37) | 0.78 (0.45–1.34) | 0.88 (0.72–1.07) | 0.186 | 945 |
| Model 2Ac | 1 (ref) | 0.75 (0.45–1.23) | 0.86 (0.53–1.41) | 0.78 (0.45–1.33) | 0.89 (0.73–1.07) | 0.220 | 1,005 |
| Dementia events [rateb] | 41 [29.6] | 33 [22.7] | 37 [26.0] | 40 [32.8] | |||
| Model 1c | 1 (ref) | 0.74 (0.47–1.18) | 0.81 (0.52–1.27) | 0.94 (0.60–1.46) | 0.97 (0.82–1.15) | 0.734 | 1,277 |
| Model 2c | 1 (ref) | 0.73 (0.44–1.22) | 0.79 (0.48–1.31) | 0.84 (0.49–1.44) | 0.91 (0.75–1.10) | 0.324 | 978 |
| Model 2Ac | 1 (ref) | 0.70 (0.42–1.17) | 0.79 (0.47–1.31) | 0.90 (0.53–1.52) | 0.94 (0.77–1.14) | 0.521 | 1,041 |
| MCI or dementia events [rateb] | 69 [53.1] | 58 [42.7] | 64 [49.6] | 61 [53.0] | |||
| Model 1c | 1 (ref) | 0.77 (0.54–1.09) | 0.85 (0.60–1.20) | 0.88 (0.62–1.25) | 0.96 (0.85–1.09) | 0.537 | 1,226 |
| Model 2c | 1 (ref) | 0.73 (0.49–1.09) | 0.79 (0.53–1.18) | 0.82 (0.54–1.25) | 0.91 (0.78–1.06) | 0.246 | 937 |
| Model 2Ac | 1 (ref) | 0.73 (0.49–1.08) | 0.80 (0.54–1.19) | 0.84 (0.56–1.26) | 0.93 (0.80–1.08) | 0.356 | 997 |
| Mean sitting bout duration (minutes) | |||||||
| Q1 (<10.1) | Q2 (10.1–12.7) | Q3 (12.7–16.2) | Q4 (≥16.2) | HR for 1-SD increment (5.4) | P-trenda | n | |
| MCI events [rateb] | 36 [30.1] | 37 [27.2] | 43 [32.9] | 41 [32.4] | |||
| Model 1c | 1 (ref) | 0.75 (0.47–1.20) | 0.94 (0.60–1.47) | 0.88 (0.55–1.39) | 0.97 (0.82–1.14) | 0.690 | 1,234 |
| Model 2c | 1 (ref) | 0.88 (0.52–1.47) | 0.99 (0.59–1.65) | 0.88 (0.51–1.51) | 0.92 (0.75–1.11) | 0.378 | 945 |
| Model 2Ac | 1 (ref) | 0.86 (0.52–1.42) | 0.98 (0.59–1.61) | 0.83 (0.49–1.42) | 0.90 (0.74–1.10) | 0.303 | 1,005 |
| Dementia events [rateb] | 33 [26.2] | 33 [22.6] | 41 [29.7] | 44 [31.9] | |||
| Model 1c | 1 (ref) | 0.71 (0.44–1.16) | 0.94 (0.59–1.50) | 0.93 (0.59–1.48) | 1.01 (0.86–1.19) | 0.859 | 1,277 |
| Model 2c | 1 (ref) | 0.67 (0.39–1.13) | 0.88 (0.52–1.46) | 0.90 (0.53–1.53) | 1.00 (0.83–1.21) | 0.979 | 978 |
| Model 2Ac | 1 (ref) | 0.72 (0.42–1.21) | 0.92 (0.55–1.54) | 1.00 (0.60–1.69) | 1.03 (0.86–1.24) | 0.739 | 1,041 |
| MCI or dementia events [rateb] | 54 [45.4] | 57 [42.0] | 71 [55.0] | 70 [55.5] | |||
| Model 1c | 1 (ref) | 0.77 (0.53–1.13) | 1.04 (0.73–1.49) | 1.00 (0.69–1.43) | 1.02 (0.90–1.15) | 0.788 | 1,226 |
| Model 2c | 1 (ref) | 0.83 (0.55–1.26) | 1.02 (0.68–1.53) | 0.96 (0.63–1.47) | 0.97 (0.84–1.13) | 0.704 | 937 |
| Model 2Ac | 1 (ref) | 0.83 (0.55–1.24) | 1.03 (0.69–1.53) | 0.98 (0.65–1.48) | 0.98 (0.85–1.13) | 0.777 | 997 |
| Light intensity steps (n/day) | |||||||
| Q1 (<1,236) | Q2 (1,236–1,693) | Q3 (1,693–2,191) | Q4 (≥2,191) | HR for 1-SD increment (728) | P-trenda | n | |
| MCI events [rateb] | 37 [32.2] | 55 [39.7] | 33 [23.5] | 42 [30.7] | |||
| Model 1c | 1 (ref) | 1.23 (0.81–1.87) | 0.74 (0.46–1.2) | 1.12 (0.71–1.75) | 1.04 (0.88–1.23) | 0.650 | 1,284 |
| Model 2c | 1 (ref) | 1.12 (0.70–1.81) | 0.78 (0.45–1.34) | 1.18 (0.69–2.04) | 1.08 (0.88–1.33) | 0.435 | 977 |
| Model 2Ac | 1 (ref) | 1.07 (0.66–1.72) | 0.79 (0.46–1.35) | 1.15 (0.67–1.97) | 1.08 (0.88–1.32) | 0.460 | 1,042 |
| Dementia events [rateb] | 45 [35.8] | 50 [33.4] | 34 [22.9] | 32 [22.1] | |||
| Model 1c | 1 (ref) | 0.96 (0.64–1.43) | 0.70 (0.44–1.09) | 0.73 (0.46–1.15) | 0.87 (0.73–1.04) | 0.118 | 1,331 |
| Model 2c | 1 (ref) | 0.81 (0.52–1.26) | 0.59 (0.35–0.99) | 0.70 (0.41–1.19) | 0.86 (0.69–1.06) | 0.156 | 1,014 |
| Model 2Ac | 1 (ref) | 0.86 (0.55–1.34) | 0.59 (0.35–0.99) | 0.69 (0.40–1.18) | 0.85 (0.69–1.05) | 0.129 | 1,082 |
| MCI or dementia events [rateb] | 62 [54.2] | 89 [65.0] | 56 [40.1] | 60 [44.1] | |||
| Model 1c | 1 (ref) | 1.22 (0.88–1.69) | 0.76 (0.53–1.10) | 0.92 (0.64–1.32) | 0.93 (0.81–1.06) | 0.280 | 1,274 |
| Model 2c | 1 (ref) | 1.10 (0.76–1.59) | 0.75 (0.49–1.14) | 0.95 (0.62–1.46) | 0.94 (0.80–1.11) | 0.472 | 967 |
| Model 2Ac | 1 (ref) | 1.09 (0.76–1.56) | 0.75 (0.50–1.13) | 0.94 (0.61–1.43) | 0.94 (0.80–1.10) | 0.433 | 1,032 |
| Moderate-to-vigorous intensity steps (n/day) | |||||||
| Q1 (<1,222) | Q2 (1,222–1,670) | Q3 (1,670–2,185) | Q4 (≥2,185) | HR for 1-SD increment (1,502) | P-trenda | n | |
| MCI events [rateb] | 52 [44.0] | 57 [44.3] | 33 [24.0] | 25 [17.1] | |||
| Model 1c | 1 (ref) | 1.00 (0.68–1.46) | 0.61 (0.39–0.96) | 0.47 (0.29–0.76) | 0.75 (0.60–0.94) | 0.011 | 1,284 |
| Model 2c | 1 (ref) | 1.04 (0.68–1.60) | 0.61 (0.36–1.02) | 0.48 (0.27–0.87) | 0.73 (0.56–0.96) | 0.024 | 977 |
| Model 2Ac | 1 (ref) | 1.01 (0.66–1.55) | 0.61 (0.37–1.02) | 0.49 (0.28–0.89) | 0.74 (0.56–0.97) | 0.027 | 1,042 |
| Dementia events [rateb] | 43 [32.5] | 56 [40.1] | 36 [24.6] | 26 [17.3] | |||
| Model 1c | 1 (ref) | 1.25 (0.84–1.87) | 0.88 (0.56–1.38) | 0.66 (0.40–1.09) | 0.87 (0.71–1.07) | 0.181 | 1,331 |
| Model 2c | 1 (ref) | 1.43 (0.90–2.27) | 1.18 (0.70–2.00) | 0.90 (0.50–1.64) | 1.00 (0.80–1.24) | 0.968 | 1,014 |
| Model 2Ac | 1 (ref) | 1.34 (0.85–2.11) | 1.09 (0.65–1.83) | 0.89 (0.49–1.59) | 0.98 (0.79–1.23) | 0.878 | 1,082 |
| MCI or dementia events [rateb] | 76 [64.8] | 93 [73.1] | 56 [40.9] | 42 [28.9] | |||
| Model 1c | 1 (ref) | 1.11 (0.82–1.51) | 0.69 (0.48–0.98) | 0.52 (0.35–0.76) | 0.76 (0.64–0.90) | 0.002 | 1,274 |
| Model 2c | 1 (ref) | 1.25 (0.88–1.77) | 0.82 (0.55–1.24) | 0.61 (0.38–0.98) | 0.80 (0.65–0.97) | 0.026 | 967 |
| Model 2Ac | 1 (ref) | 1.20 (0.85–1.69) | 0.80 (0.54–1.19) | 0.63 (0.40–0.99) | 0.80 (0.65–0.97) | 0.027 | 1,032 |
Abbreviations: MCI=mild cognitive impairment
a
P-values from Cox models with accelerometer measures in continuous form.
b
Crude incidence rate per 1000 person-years
c
Data are hazard ratio (95% confidence interval)
Model 1 adjusted for age, race and ethnicity, and education; Model 2 = Model 1 + smoking status + alcohol use + diabetes + hypertension + RAND-36 physical functioning score + APOE ε4 + BMI
*
p<0.05 (p=0.047)
Model 2A results were estimated with missing covariate data for women with APOE ε4 data imputed using multiple imputation by chained equations (MICE) from the R mice package.