Table 1.
Characteristics of studies.
| Author (Year), Country | Study Population | Follow-Up Years Mean | ST Measure (Mean or Median Time) | Covariates (Number of Covariates) | Cut-off (h/d) | Cox Regression HR (95% CIs) | Quality | ||
|---|---|---|---|---|---|---|---|---|---|
| n (Death) | Age Mean (±SD) | Male (%) | |||||||
| Koster et al., 2012, USA [22] | 1091 (126) | ≥65 M = 74.7 (±6.5) |
68.8% | 2.8 y | Objectively measured SB < 100 counts/1 min [AM-7164 ActiGraph] (ST median: male = 9.18, female = 8.68 h) | Age, sex, race/ethnicity, education, BMI, diabetes, coronary heart disease, congestive heart failure, cancer, stroke, mobility limitation, smoking, alcohol, MVPA, accelerometer wear time (15) | Quartile: male/female | 1.0 | |
| <7.6/<7.2 (ref.) | 1.00 | ||||||||
| >7.6–≤9.18/ > 7.2–≤8.68 |
1.55 (0.44–5.54) | ||||||||
| >9.18–≤10.75/ >8.68–≤10.09 |
3.13 (1.17–8.39) * | ||||||||
| >10.75/>10.09 | 4.18 (1.70–10.31) * | ||||||||
| Ensrud et al., 2014, USA [15] | 2918 (409) | ≥71 M = 79 (±5.2) |
100% | 4.5 y | Objectively measured SB ≤ 1.50 METs [sensewear pro armband] (ST median = 14.08 h) |
Age, sex, race, education, marital status, site, season, health status, comorbidity burden, depressive symptoms, cognitive function, body fat %, number of instrumental activity of daily living impairments, smoking, sleep time, gait speed, self-reported total PA (17) ¶ | ≤12.86 (ref.) | 1.00 † | 0.95 |
| 12.87–14.08 | 1.30 (0.93–1.81) | ||||||||
| 14.09–15.24 | 1.19 (0.83–1.70) | ||||||||
| >15.24 | 1.79 (1.19–2.70) * | ||||||||
| § Fox et al., 2015, UK [9] | 208 (32) |
≥70 M = 78 (±5.7) |
51.2% | 4.3 y | Objectively measured SB < 100 counts/1 min [Actigraph GT1Ms] (ST median = 11.03 h) |
Age, sex, educational, index of multiple deprivation, weight status, general practitioner system, number of self-reported chronic illnesses at baseline, lower limb function (9) ¶; Re-analysis further including MVPA & accelerometer wear time = 11) | <10.55 (ref.) | 1.00 | 1.0 |
| ≥10.55–11.59 | 1.01 (0.39–2.56) | ||||||||
| ≥11.6 | 0.99 (0.34–2.86) | ||||||||
| Schmid et al., 2015, USA [14] | 1677 (112) | ≥50 M = 67.2 ‡ |
49% | 2.9 y | Objectively measured SB < 100 counts/1 min [AM-7164 ActiGraph] (ST median = 8.6 h) |
Age, sex, education, ethnicity, history of diabetes, cardiovascular disease, cancer, mobility limitations, BMI, smoking, alcohol, light PA, MVPA (13) ¶ | <8.60 (ref.) | 1.00 | 0.95 |
| ≥8.60 | 1.59 (0.84–3.03) †† | ||||||||
| Lee, 2016, USA [23] | 1768 (453) | ≥65 M = 74.7 (±6.5) |
51.8% | 6.3 y | Objectively measured SB < 100 counts/1 min [AM-7164 ActiGraph] (ST median = 10.0 h) |
Age, sex, education, income, BMI, self-reported general health, condition, high blood pressure, high cholesterol, type 2 diabetes, history of heart attack, stroke, cancer, energy intake by 24-h dietary recall, binge drinking, smoking, MVPA, accelerometer wear time (18) | Quartile | 1.0 | |
| ≥4.6–<8.8 (ref.) | 1.00 | ||||||||
| ≥8.8–<10.0 | 1.28 (0.82–1.99) | ||||||||
| ≥10.0–<11.6 | 1.36 (0.89–2.09) | ||||||||
| ≥11.6–<20.8 | 1.87 (1.22–2.86) * | ||||||||
| Klenk et al., 2016, Southern Germany [8] | 1271 (100) |
≥65 M = 75.6 (±6.51) |
46.4% | 4 y | Objectively measured lying or sitting activPAL (ST median = 11.75 h) |
Age, sex, education, BMI, diabetes, hypertension, cardiovascular disease, cancer, chronic kidney disease, blood glucose. smoking, alcohol, walking time (which includes light, moderate and vigorous intensity physical activity) (13) ¶ | 5.85–<10.4 (ref.) | 1.00 | 0.95 |
| ≥10.4–<11.75 | 1.10 (0.54–2.24) | ||||||||
| ≥11.75–<12.94 | 0.65 (0.31–1.35) | ||||||||
| ≥12.94–<17.21 | 1.62 (0.85–3.07) | ||||||||
| Diaz et al., 2017, USA [11] | 7985 (340) |
≥45 M = 69.8 ‡ |
45.8% | 4 y | Objectively measured SB < 50 counts/1 min [Actical-Philips Respironics] (ST median = 12.44 h) |
Age, sex, race, region of residence, education, season, BMI, diabetes, hypertension, dyslipidemia, estimated glomerular filtration rate < 60 mL/min/1.73 m2, atrial fibrillation, history of coronary heart disease, stroke, smoking, alcohol, MVPA, standardized 16 h of accelerometer wear (18) | <11.50 (ref.) | 1.00 † | 1.0 |
| ≥11.50–<12.44 | 1.22 (0.74–2.02) | ||||||||
| ≥12.44–<13.32 | 1.61 (0.99–2.63) | ||||||||
| ≥13.32 | 2.63 (1.60–4.30) * | ||||||||
| Dohrn et al., 2017, Sweden [17] | 851 (79) |
≥35 M = 66.7 (±10.2) |
44.1% | 14.2 y | Objectively measured SB < 100 counts/1 min [AM-7164ActiGraph] (ST mean = 8.20 h) |
Age, sex, education, hypertension, heart disease, cancer, diabetes, BMI, smoking, MVPA, accelerometer wear time (11) | 6.55–<8.20 (ref.) | 1.00 | 1.0 |
| 8.20–<9.83 | 1.88 (0.99–3.55) | ||||||||
| ≥9.83 | 2.72 (1.40–5.30) * | ||||||||
| Koolhaas et al., 2017, The Netherlands [21] | 650 (148) |
65–98 M = 72.6 a |
47.4% | 11 y | Objectively measured SB ≤ 199 counts/1 min [Actiwatch model AW4] (ST mean = 9.28 h [1.86]; median = 9.20 h) |
Age, sex, education, number of comorbidities, the 24 h activity rhythm, activities of daily living score, smoking, alcohol, MVPA, cohort and time awake (10) | <8 (ref.) | 1.00 | 0.95 |
| 8–<11 | 1.21 (0.71–2.04) | ||||||||
| ≥11 | 1.58 (0.87–2.88) | ||||||||
| Jefferis et al., 2018, UK [12] | 1181 (194) |
71–92 M = 78.4 (±4.6) |
100% | 5.0 y | Objectively measured SB < 100 counts/1 min [ActiGraph GT3X] (ST mean = 10.3 h) |
Age, sex, region of residence, living alone, season of wear, social class, BMI, mobility disability, alcohol, smoking, sleep time, MVPA, accelerometer wear time (13) | 4.9–<9.3 (ref.) | 1.00 | 1.0 |
| ≥9.3–<10.3 | 1.14 (0.69–1.91) | ||||||||
| ≥10.3–<11.2 | 1.55 (0.91–2.64) | ||||||||
| ≥11.2–<17.6 | 2.73 (1.50–4.95) * | ||||||||
| Lee et al., 2018, USA [13] | 16,741 (207) |
M = 72.0 (±5.7) |
0% | 2.3 y | Objectively measured SB < 200 counts/1 min [ActiGraph Corp] (ST mean = 8.4 h) |
Age, sex, hormone therapy, parental history of myocardial infarction, family history of cancer, general health, cardiovascular disease, cancer, cancer screening, smoking, alcohol, intakes of saturated fat/fiber/fruits/ vegetables, MVPA, accelerometer wear time (14) | <7.24 (ref.) | 1.00 | 1.0 |
| ≥7.24–<8.38 | 0.97 (0.62–1.50) | ||||||||
| ≥8.38–<9.51 | 1.18 (0.77–1.82) | ||||||||
| ≥9.51 | 0.92 (0.56–1.50) | ||||||||
| Average of total n (death) = 3303 (200) Total n = 36,341/ Deceased n = 2200 |
Total sample M (±SD) age = 73.5 (±4.3) y Total follow-up M (±SD) year = 5.6 (±3.7) y |
Total weighted average of ST = 10.08 h | M = 0.98 | ||||||
* p < 0.05; p for trend. †: significant (p < 0.05); ‡: Two studies did not report mean age of the study samples. The mean age of these studies was recalculated as follows: ∑ (median age of an age group) × (sample size of a age group) divided by the total sample size [11,14]. a: One study reported mean age but did not provide SD of sample age [21]; §: After further adjusting MVPA and accelerometer wearing, the HRs (95% CI) for Fox’s study were recalculated as follows: <10.55 h: 1.00 (ref.); 10.55–11.59 h: 1.16 (0.37–3.65); ≥11.6 h: 2.00 (0.53–7.58); ¶: covariates without including MVPA or accelerometer wear time; ††: The results excluding deaths that occurred during the first year of follow up. Abbreviations: BMI, body mass index; M, mean; y, years; HR, hazard ratio; CIs, confidence intervals; h/d, hour/day; PA, physical activity; MVPA, moderate to vigorous physical activity; SD, standard deviation; ST, sedentary time.