Are associations of leisure-time physical activity with mortality attenuated by high levels of chronic ambient fine particulate matter (PM2.5) in older adults? A prospective cohort study

Po-Wen Ku; Andrew Steptoe; Yun-Ju Lai; Yung-Feng Yen; Matthew Ahmadi; Elif Inan-Eroglu; Su-Fen Wang; Li-Jung Chen; Emmanuel Stamatakis

doi:10.1016/j.exger.2023.112148

Are associations of leisure-time physical activity with mortality attenuated by high levels of chronic ambient fine particulate matter (PM_2.5) in older adults? A prospective cohort study

Exp Gerontol. 2023 May:175:112148. doi: 10.1016/j.exger.2023.112148. Epub 2023 Mar 23.

Authors

Po-Wen Ku¹, Andrew Steptoe², Yun-Ju Lai³, Yung-Feng Yen⁴, Matthew Ahmadi⁵, Elif Inan-Eroglu⁶, Su-Fen Wang⁷, Li-Jung Chen⁸, Emmanuel Stamatakis⁹

Affiliations

¹ Graduate Institute of Sports and Health Management, National Chung Hsing University, 402 Taichung, Taiwan; Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; Department of Kinesiology, National Tsing Hua University, Hsinchu City 402, Taiwan. Electronic address: powen.ku@nchu.edu.tw.
² Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK. Electronic address: a.steptoe@ucl.ac.uk.
³ Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou 545, Taiwan; School of Medicine, National Yang-Ming Chiao Tung University, 112, Taiwan.
⁴ Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei 111, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁵ Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia. Electronic address: matthew.ahmadi@sydney.edu.au.
⁶ Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany. Electronic address: elif.inaneroglu@sydney.edu.au.
⁷ Department of Geography, National Changhua University of Education, Changhua City 500, Taiwan. Electronic address: sfwang@cc.ncue.edu.tw.
⁸ Department of Exercise Health Science, National Taiwan University of Sport, 404, Taiwan; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK. Electronic address: ljchen@gm.ntus.edu.tw.
⁹ Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia. Electronic address: emmanuel.stamatakis@sydney.edu.au.

PMID: 36931451
DOI: 10.1016/j.exger.2023.112148

Abstract

Background and purpose: Although leisure-time physical activity (PA) has established health benefits in older adults, it is equivocal if exercising in environments with high levels of PM_2.5 concentrations is equally beneficial for them. To explore the independent and joint associations of ambient PM_2.5 and PA with all-cause mortality among adults aged 60 or older and to assess the modifying effect of age (60-74 years vs. 75+ years) on the joint associations.

Methods: A prospective cohort study based on the MJ Cohort repeat examinations (2005-2016) and the Taiwan Air Quality Monitoring Network and death registry linkages (2005-2022). We included MJ Cohort participants aged 60 or more at baseline who attended the health check-ups at least twice (n = 21,760). Metabolic equivalent hours per week (MET-h/week) of leisure-time PA were computed. Multivariable adjusted associations were examined using time-varying Cox proportional hazard models.

Results: There were 3539 all-cause deaths over a mean follow-up of 12.81 (SD = 3.67) years. Ambient PM_2.5 and physical inactivity are both independently associated with all-cause mortality. The joint associations of PA and PM_2.5 concentrations with all-cause mortality differed in the young-old (60-74 years) and the older-old (75+ years) (P for interaction = 0.01); Higher levels of long-term PM_2.5 exposures (≥25 μg/m³) had little influence on the associations between PA and mortality in the young-old (HR = 0.68 (0.56-0.83) and HR = 0.72 (0.59-0.88) for participants with 7.5-<15 and 15+ MET-h/week respectively) but eliminated associations between exposure and outcome in the older-old (HR = 0.91 (0.69-01.21) and HR = 1.02 (0.76-1.38) for participants with 7.5-<15 and 15+ MET-h/week).

Conclusion: Long-term exposures to higher PM_2.5 concentrations may eliminate the beneficial associations of PA with all-cause mortality among adults aged 75 and over.

Keywords: Aging; Air pollution; Air quality; Death; Exercise.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Air Pollutants* / adverse effects
Air Pollutants* / analysis
Environmental Exposure / analysis
Exercise
Humans
Leisure Activities
Particulate Matter* / adverse effects
Prospective Studies

Substances

Particulate Matter
Air Pollutants