Association of accelerometer-monitored physical activity with incident cataract: epidemiological and genetic evidence

To investigate the association and potential causal relationship between accelerometer-assessed physical activity (PA) and the risk of senile cataract (SC).

The study population was derived from the UK Biobank database. Triaxial accelerometer data from wearable devices, collected over a continuous 7-day wear period (accounting for potential seasonal variation), were used to define PA at light (LPA), moderate (MPA), and vigorous (VPA) intensities. Multivariable Cox proportional hazards models were used to examine the association between PA intensity-specific domains and SC incidence. Furthermore, two-sample Mendelian randomisation (MR) analyses were conducted using genome-wide association data from multiple large-scale prospective study cohorts (UK Biobank for PA and FinnGen for SC) to elucidate potential causality.

The study ultimately enrolled 77,123 participants with a mean age of 55.67 ± 7.8 years. During a mean follow-up of 6.3 years (interquartile range [IQR]: 5.3-7.3 years), 1194 incident SC cases were identified. Compared with insufficient activity, achieving 150-600 min of moderate to vigorous-intensity PA (MVPA) per week was associated with a 21% lower risk of SC (HR = 0.79, 95% CI: 0.68-0.91). Dose-response analyses revealed U-shaped associations for MPA and MVPA, with the lowest risk observed at moderate volumes. For other intensities, engaging in ≥300 min/week of MPA was associated with reduced risk (HR = 0.78, 95% CI: 0.66-0.92), while no significant associations were observed for LPA or VPA alone. MR analysis supported a causal relationship, indicating that genetically proxied higher MVPA was associated with a lower risk of SC (OR = 0.56, 95% CI: 0.38-0.83, P = 0.004).

Adhering to the PA guidelines established by the World Health Organization emerges as a novel and modifiable protective measure to delay the progression of SC.