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Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults: A National Cohort Study

Annals of Internal Medicine is the premier internal medicine academic journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world.

Although total sedentary time has been associated with increased mortality, most studies have relied on participant recall to report activity. Whether longer or shorter bouts of inactivity are associated with different outcomes is not known. This large cohort study objectively measured physical activity to assess total as well as shorter and longer bouts of sedentary time.

Use this paper to:

  • Consider how much of your day is spent sitting. Do you engage in routine physical exercise? How intense is it?
  • Do the results of this study alter how you think about the importance of physical activity? Does engaging in moderate-to-vigorous physical activity alter the association between sedentary time and mortality? Does it “protect” us from our sedentary habits?
  • In addition to total sedentary time, the authors examined longer and shorter bouts of sedentary time. Why? What did they find? How might these variables alter the risk for death? Use the accompanying editorial to help frame your thoughts.
  • Teach at the bedside! Ask patients what their daily activities involve and how much of their time is sedentary. Would they be able to alter that if they wanted to? What could be recommended? Should we make recommendations based on this study?
  • Learn what confounding is and how it might be important in an observational study such as this. The authors quantified the potential effect of an “unmeasured confounder” on their findings. What is an unmeasured confounder? How do the results of this sensitivity analysis help to provide confidence in the authors' conclusions? Use a recent editorial to help frame your discussion.

Also, don't miss this month's Annals Graphic Medicine, featuring a medical student in the role of the superhero.

Annals of Internal Medicine is the premier internal medicine academic journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world.

Back to the November 2017 issue of ACP IMpact