Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Sedentary Behavior and Mortality in Older Adults

Ann Intern Med; ePub 2017 Sep 12; Diaz, et al

In middle-aged and older adults, both the total volume of sedentary time and its accrual in prolonged, uninterrupted sessions are associated with all-cause mortality, a recent study found. The study included 7,985 black and white adults aged ≥45 years and examined the association between objectively measured sedentary behavior and all-cause mortality. Hazard ratios (HRs) were calculated comparing quartiles 2 through 4 to quartile 1 for each exposure in models that included moderate-to-vigorous physical activity. Researchers found:

  • Over a median follow-up of 4 years, 340 participants died.
  • Greater sedentary time (HR 1.22, 1.61, and 2.63) and longer sedentary bout duration (HR 1.03, 1.22, and 1.96) were both associated with a greater risk for all-cause mortality.
  • Participants classified as high for both sedentary characteristics (high sedentary time and high bout duration) had the greatest risk for death.


Diaz KM, Howard VJ, Hutto B, et al. Patterns of sedentary behavior and mortality in U.S. middle-aged and older adults: A national cohort study. [Published online ahead of print September 12, 2017]. Ann Intern Med. doi:10.7326/M17-0212.


This study lends further support to the growing body of evidence deomonstrating that prolonged periods of inactivity, i.e., sedentary behavior, is hazardous to your health. Sedentary behavior is distinct from a lack of moderate-to-vigorous physical activity (MVPA), and it is concerning that even those individuals who spend more time engaged in MVPA often have similar sedentary time as those who are less physically active. Sedentary behavior is a risk factor for cardiovascular disease, diabetes mellitus, and all-cause mortality.1 When we counsel patients, we should counsel about diet and exercise, as well as decreasing sedentary behavior. —Neil Skolnik, MD

  1. Young DR, Hivert MF, Alhassan S, et al. Sedentary behavior and cardiovascular morbidity and mortality: A science advisory from the American Heart Association. Circulation. 2016;134(13):262-79. doi:10.1161/CIR.0000000000000440.