Background: Moderate-to-vigorous physical activity (MVPA) protects against cardiovascular disease (CVD) but less is known about how different physical activity (PA) patterns influence CVD risk. This study examined these associations considering age-related differences.
Methods: Data from 423 CVD-free participants from the Swedish SNAC-K study were analyzed. Accelerometer data was collected from 2016 to 2019 and CVD events (fatal and non-fatal) over an 8-year period were obtained from national registers. Cox regression models were employed to assess associations between PA patterns-including steps per day, sit-to-stand transitions, daily time in light PA (LPA) and MVPA, and walking events (i.e. daily number of LPA or MVPA walking bouts)-and CVD risk. Cubic splines evaluated non-linear relationships, and interactions between PA and age-group (=66 vs. ≥80 years) were explored.
Results: Over a mean follow-up period of 5.6 years, 125 participants (30%) experienced at least one CVD event. In the total sample, each additional 10 MVPA walking events reduced CVD risk (HR 0.90, 95% CI 0.82-0.98, p=0.019). Among the oldest-old, each additional 100 LPA walking events (HR 0.61, 95% CI 0.39-0.95, p=0.027) and each additional 10 MVPA walking events (HR 0.87, 95% CI 0.76-0.98, p=0.024) reduced CVD risk. No clear associations were observed in younger-old adults.
Conclusions: In this cohort of generally well-functioning older adults, frequent daily engagement in MVPA was associated with a reduced risk of incident CVD. Among the oldest-old, recurrent participation in both LPA and MVPA was linked to lower CVD risk, highlighting the importance of frequent daily PA.
Keywords: Accelerometer; Cardiovascular disease; Cohort; Light Physical Activity; Moderate-to-Vigorous Physical Activity; Older adults.
Older adults (66 years or above) who frequently engaged in daily moderate- to-vigorous physical activity (MVPA) had a lower risk of cardiovascular disease (CVD) events, while the oldest adults (80 years or above) also benefited from a higher frequency of light physical activity (LPA), underscoring the benefits of increasing the daily frequency of walking episodes. In the total sample, each additional 10 episodes of walking in MVPA per day, lowered the risk of CVD events.For the oldest adults, every additional 100 episodes of walking in LPA and every additional 10 episodes of walking in MVPA per day reduced the risk of CVD events. No clear associations were seen in younger-old adults (under =66 years), likely due to already high PA levels within this subgroup.
© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.