Accelerometer-derived movement profiles incorporating volume, intensity, and transition dynamics: associations with...

Comprehensive assessments of daily movement patterns in older adults remain limited. This study aimed to identify accelerometer-derived activity profiles among adults aged 60 years and older and examine their associations with chronic disease prevalence and mortality.

We analyzed minute-level waking-hour accelerometer data from 2253 older adults in NHANES 2003-2006. Cluster analysis was performed using total log-transformed activity counts (TLAC), moderate-to-vigorous physical activity (MVPA), sedentary-to-active transition probability (SATP), and active-to-sedentary transition probability (ASTP), which identified four activity profiles. Survey-weighted logistic regression estimated odds ratios (OR) for chronic disease prevalence, and survey-weighted Cox models estimated hazard ratios (HR) for all-cause and cardiovascular mortality.

Cluster 1 had the lowest activity and greatest fragmentation, whereas Cluster 4 had the highest activity, highest SATP, and lowest ASTP. Compared with Cluster 1, Cluster 4 had lower odds of diabetes (OR, 0.33; 95 % CI, 0.16-0.68) and all-cause mortality (HR, 0.38; 95 % CI, 0.28-0.51). Clusters 2 and 3 also had lower all-cause mortality (HR, 0.62; 95 % CI, 0.53-0.73; and HR, 0.50; 95 % CI, 0.41-0.60). For cardiovascular mortality, Clusters 2 and 3 showed lower risks (HR, 0.71; 95 % CI, 0.52-0.97; and HR, 0.64; 95 % CI, 0.44-0.91), whereas Cluster 4 was not significant.

These findings suggest that accelerometer-derived activity profiles characterized by higher overall physical activity and fewer transitions to sedentary states are associated with lower chronic disease prevalence and lower subsequent mortality risk among older adults.