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Sedentary Behavior and Incident Dementia Among Older Adults
Raichlen DA, Aslan DH, Sayre MK, Bharadwaj PK, Ally M, Maltagliati S, Lai MHC, Wilcox RR et al.. JAMA, 2023-09-01
Topic: Risk, prevention and care in population studies
Importance Sedentary behavior is associated with cardiometabolic disease and mortality, but its association with dementia is unclear. Objective To investigate whether accelerometer-assessed sedentary behavior is associated with incident dementia. Design, setting, and participants A retrospective study of prospectively collected data from the UK Biobank including 49 841 adults aged 60 years or older without a diagnosis of dementia at the time of wearing the wrist accelerometer and living in England, Scotland, or Wales. Follow-up began at the time of wearing the accelerometer (February 2013 to December 2015) and continued until September 2021 in England, July 2021 in Scotland, and February 2018 in Wales. Exposures Mean daily sedentary behavior time (included in the primary analysis) and mean daily sedentary bout length, maximum daily sedentary bout length, and mean number of daily sedentary bouts (included in the secondary analyses) were derived from a machine learning-based analysis of 1 week of wrist-worn accelerometer data. Main outcome and measures Incident all-cause dementia diagnosis from inpatient hospital records and death registry data. Cox proportional hazard models with linear and cubic spline terms were used to assess associations. Results A total of 49 841 older adults (mean age, 67.19 [SD, 4.29] years; 54.7% were female) were followed up for a mean of 6.72 years (SD, 0.95 years). During this time, 414 individuals were diagnosed with incident all-cause dementia. In the fully adjusted models, there was a significant nonlinear association between time spent in sedentary behavior and incident dementia. Relative to a median of 9.27 hours/d for sedentary behavior, the hazard ratios (HRs) for dementia were 1.08 (95% CI, 1.04-1.12, P Conclusions and relevance Among older adults, more time spent in sedentary behaviors was significantly associated with higher incidence of all-cause dementia. Future research is needed to determine whether the association between sedentary behavior and risk of dementia is causal.
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APA 7th
Raichlen, D. A., Aslan, D. H., Sayre, M. K., Bharadwaj, P. K., Ally, M., Maltagliati, S., et al. (2023). Sedentary Behavior and Incident Dementia Among Older Adults. JAMA. https://doi.org/10.1001/jama.2023.15231
Vancouver
Raichlen DA, Aslan DH, Sayre MK, Bharadwaj PK, Ally M, Maltagliati S, et al. Sedentary Behavior and Incident Dementia Among Older Adults. JAMA. 2023. doi:10.1001/jama.2023.15231. PMID: 37698563.
BibTeX
@article{raichlen2023-37698563,
author = {Raichlen, D. A. and Aslan, D. H. and Sayre, M. K. and Bharadwaj, P. K. and Ally, M. and Maltagliati, S. and Lai, M. H. C. and Wilcox, R. R. and others},
title = {{Sedentary Behavior and Incident Dementia Among Older Adults}},
journal = {JAMA},
year = {2023},
doi = {10.1001/jama.2023.15231},
pmid = {37698563},
url = {https://doi.org/10.1001/jama.2023.15231}
}
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Key findings
- Importance Sedentary behavior is associated with cardiometabolic disease and mortality, but its association with dementia is unclear.
- Objective To investigate whether accelerometer-assessed sedentary behavior is associated with incident dementia.
- Results A total of 49 841 older adults (mean age, 67.19 [SD, 4.29] years; 54.7% were female) were followed up for a mean of 6.72 years (SD, 0.95 years).
- In the fully adjusted models, there was a significant nonlinear association between time spent in sedentary behavior and incident dementia.
- Relative to a median of 9.27 hours/d for sedentary behavior, the hazard ratios (HRs) for dementia were 1.08 (95% CI, 1.04-1.12, P Conclusions and relevance Among older adults, more time spent in sedentary behaviors was significantly associated with higher incidence of all-cause dementia.
Why it matters
In 49,841 older adults followed for a mean of 6.72 years, accelerometer-assessed sedentary behavior showed a significant nonlinear association with incident dementia. This is an observational association and does not show that changing sedentary behavior prevents or treats dementia.
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Study details
- Participants841
- Effect size54.7%
- Evidence strengthLow
How this study scored 63/100
Published in a top-tier journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 2 / 4 | 841 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 155 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 31.0 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 5 / 6 | Cited 22.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 8 other studies in this library |
| Still being cited | 3 / 4 | Cited 154 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Gene E. Alexander: h-index 80 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Southern California: institution h-index 1,521 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 37698563) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 63 / 100 | — |
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