Changes in physical activity and mortality risk among an adult Lithuanian urban population: results from a cohort study

Objectives: The purpose of this study was to investigate changes in physical activity and the association of these changes with the risk of all-cause mortality and mortality from cardiovascular disease (CVD) among an adult and elderly Lithuanian urban population. Study design: Prospective cohort study. Methods: Data from four surveys are presented. In total, there were 2416 participants (1071 men and 1345 women) who took part in one of the initial three surveys in the framework of the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study since 1986 and also in the follow-up survey in 2006 (with follow-up over 15 years). Study participants were followed-up for mortality events from 2006 until 31 December 2017. The mean duration of the follow-up for endpoints period was 10.55 (standard deviation 2.33) years. Results: Over 15 years of follow-up, 50.9% of men and 56.7% of women were physically active at initial and follow-up surveys, and approximately 10.0% of respondents were physically inactive. Over this period, 22.8% of men and 24.8% of women increased their physical activity level, and 14.1% of men and 10.1% of women decreased their physical activity level. The findings from the Cox proportional hazards regression multivariable analysis showed that a decrease in physical activity level during the follow-up period was related to a higher risk for all-cause mortality and mortality from CVD risk in women (hazard ratio [HR] = 1.82, P = 0.039; and HR = 5.40, P = 0.014, respectively). In men, a clear association of physical inactivity was ascertained only to all-cause mortality risk and only for non-smokers (HR = 2.07, P = 0.013). Conclusions: A decrease in physical activity levels in women is a strong predictor for all-cause mortality risk and mortality from CVD risk. Physical inactivity in male non-smokers is a strong predictor for all-cause mortality risk. (C) 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.