Background
Methods
Study population
The Women’s Health Initiative, Extension Studies and Long Life Study
Cardiovascular disease outcomes
Study Outcome | Definition and Confirmation of Outcomes |
---|---|
Non-fatal myocardial infarction | Standardized criteria for diagnostic electrocardiography changes, elevated cardiac enzymes or both |
Revascularization | Documentation of the procedure in the medical record. |
Angina | Hospital record, angiography evidence, diagnostic stress test, or documented physician diagnosis and medical treatment |
Congestive heart failure | Hospital record and diagnostic confirmatory tests |
Fatal coronary heart disease | Documentation in the hospital record, autopsy report or cause of death on the death certificate with evidence of previous coronary heart disease |
Stroke | Documentation in the medical record of neurologic deficit of rapid onset consistent with stroke and lasting for at least 24 h or until death |
Death from other cardiovascular disease | Confirmatory evidence in the medical records as ascertained by physician adjudicators |
OPACH falls surveillance and data collection
Accelerometer data collection
Accelerometer data processing
Covariate data collection
Survey Measure | Question Number | Source (within References) |
---|---|---|
WHI self-reported physical activity | 1–4 | [17] |
Borg scale assessment of relative intensity | 5 | [32] |
Rating of perceived capacity scale | 6–7 | [33] |
WHI self-reported sedentary behavior | 8–10 | [17] |
CARDIA study sedentary behavior scale | 11–12 | |
Short Falls Efficacy Scale International | 13 | [36] |
Participation in falls prevention programs | 18–19 | Original, newly developed questions |
Falls history assessment | 20–21 | [37] |
Engagement in physical activity during fall and injurious fall; injurious fall history assessment | 22–26 | Original, newly developed questions |
Urban environment and physical activity | 27 | [38] |
Neighborhood Environmental Walkability Scale - select subscales (neighborhood type and crime safety) | 28–29 | [39] |
CHAMPS self-reported physical activity assessment | 30 | [40] |
OPACH calibration study
3
.Intensity Level | Vector Magnitude Cutpoint Values (counts per 15-s) |
---|---|
Sedentary | 0–18 |
Low light | 19–225 |
High light | 226–518 |
Moderate-to-Vigorous | ≥519 |
Baseline characteristics
Age Group, years | ||||||
---|---|---|---|---|---|---|
Total | 63–69 | 70–79 | 80–89 | 90+ |
p-value | |
N (%) | 6489 | 666 (10.3) | 2600 (40.1) | 2953 (45.5) | 270 (4.2) | |
Race/Ethnicity, n (%) | ||||||
Non-Hispanic White | 3205 (49.4) | 94 (2.9) | 697 (21.8) | 2192 (68.4) | 222 (6.9) | <0.001 |
Non-Hispanic Black | 2187 (33.7) | 373 (17.1) | 1264 (57.8) | 511 (23.4) | 39 (1.8) | |
Hispanic/Latina | 1097 (16.9) | 199 (18.1) | 639 (58.3) | 250 (22.8) | 9 (0.8) | |
Education, n (%) | ||||||
High School or less | 1316 (20.4) | 101 (7.7) | 499 (37.9) | 652 (49.5) | 64 (4.9) | 0.002 |
Some College | 2496 (38.7) | 267 (10.7) | 1024 (41.0) | 1111 (44.5) | 94 (3.8) | |
College Graduate or more | 2634 (40.9) | 293 (11.1) | 1056 (40.1) | 1174 (44.6) | 111 (4.2) | |
Current Smoker, n (%) | 164 (2.8) | 35 (21.3) | 81 (49.4) | 47 (28.7) | 1 (0.6) | <0.001 |
Alcohol Use, n (%) | ||||||
Non-drinker | 2230 (37.9) | 203 (9.1) | 912 (40.9) | 1022 (45.8) | 93 (37.8) | 0.12 |
< 1 drink per week | 2008 (34.1) | 210 (10.5) | 820 (40.8) | 889 (44.3) | 89 (36.2) | |
≥ 1 drink per week | 1651 (28.0) | 176 (10.7) | 617 (37.4) | 794 (48.1) | 61 (26.0) | |
Excellent or Very Good Self-Rated Health, n (%) | 2977 (50.8) | 338 (11.4) | 1216 (40.9) | 1321 (44.4) | 102 (3.4) | <0.001 |
RAND SF-36 Physical Function Score, mean (SD) | 67.9 (26.0) | 78.9 (23.1) | 73.0 (25.0) | 62.5 (25.3) | 48.3 (25.3) | <0.001 |
Depressive Symptoms Score, mean (SD) | 0.03 (0.11) | 0.04 (0.15) | 0.03 (0.12) | 0.02 (0.09) | 0.01 (0.07) | <0.001 |
Self-Reported Physical Activity, MET-hrs/week, mean (SD) | 11.9 (14.0) | 15.0 (16.5) | 13.3 (14.8) | 10.4 (12.8) | 6.6 (8.9) | <0.001 |
CHAMPS Expenditure, MET-hrs/week, mean (SD) | 29.1 (26.8) | 34.8 (32.2) | 31.7 (29.0) | 26.5 (23.4) | 18.9 (18.3) | <0.001 |
CARDIA Scale, sedentary hours/week, mean (SD) | 56.4 (22.7) | 58.3 (25.3) | 57.8 (24.1) | 54.7 (20.6) | 54.7 (20.9) | <0.001 |
Falls in past 12 months, n (%) | ||||||
None | 4503 (69.4) | 493 (11.0) | 1870 (41.5) | 1974 (43.8) | 166 (3.7) | <0.001 |
One time | 1258 (19.4) | 112 (8.9) | 484 (38.5) | 602 (47.9) | 60 (4.8) | |
Two or more times | 728 (11.2) | 61 (8.4) | 246 (33.8) | 377 (51.8) | 44 (6.0) | |
Falls Efficacy Score, mean (SD) | 10.7 (4.2) | 9.6 (3.8) | 10.1 (3.8) | 11.3 (4.3) | 13.3 (5.1) | <0.001 |
Short Physical Performance Battery score, mean (SD) | 8.2 (2.5) | 9.2 (2.1) | 8.6 (2.3) | 7.7 (2.6) | 6.5 (2.9) | <0.001 |
Systolic Blood Pressure, mean (SD) | 125.7 (14.3) | 122.6 (12.9) | 125.2 (13.8) | 126.6 (14.7) | 127.9 (16.4) | <0.001 |
Diastolic Blood Pressure, mean (SD) | 72.5 (8.8) | 73.6 (8.1) | 73.3 (8.6) | 71.8 (9.0) | 71.0 (9.2) | <0.001 |
Waist, inches, mean (SD) | 35.5 (5.5) | 36.1 (5.5) | 36.1 (5.7) | 35.0 (5.2) | 33.8 (5.1) | <0.001 |
Weight, lbs, mean (SD) | 158.4 (34.4) | 171.8 (37.5) | 166.1 (35.9) | 150.6 (30.0) | 138.3 (25.9) | <0.001 |
Body Mass Index, kg/m2, mean (SD) | 28.2 (5.8) | 29.9 (6.2) | 29.3 (6.1) | 27.1 (5.2) | 25.9 (4.8) | <0.001 |
Body Mass Index Categories, n (%) | ||||||
< 25 kg/m2
| 1944 (32.1) | 128 (6.6) | 627 (32.3) | 1065 (54.8) | 124 (6.4) | <0.001 |
25–<30 kg/m2
| 2199 (36.3) | 209 (9.5) | 868 (39.5) | 1032 (46.9) | 90 (4.1) | |
≥ 30 kg/m2
| 1917 (31.6) | 259 (13.5) | 938 (48.9) | 677 (35.3) | 43 (2.2) | |
Medical History | ||||||
Stroke | 459 (7.1) | 21 (4.6) | 134 (29.2) | 271 (59.0) | 33 (7.2) | <0.001 |
Congestive Heart Failure | 133 (2.1) | 9 (6.8) | 41 (30.8) | 73 (54.9) | 10 (7.5) | 0.013 |
Total CVD | 1327 (20.5) | 92 (6.9) | 472 (35.6) | 687 (51.8) | 76 (5.7) | <0.001 |
Hip fracture | 188 (2.9) | 4 (2.1) | 24 (12.8) | 133 (70.7) | 27 (14.4) | <0.001 |
Any clinical fracture | 2202 (33.9) | 150 (6.8) | 775 (35.2) | 1156 (52.5) | 121 (5.5) | <0.001 |
Diabetes | 2078 (32.0) | 237 (11.4) | 933 (44.9) | 846 (40.7) | 62 (3.0) | <0.001 |
Osteoarthritis | 4000 (61.6) | 404 (10.1) | 1599 (40.0) | 1817 (45.4) | 180 (4.5) | 0.36 |
Invasive cancer | 992 (15.3) | 72 (7.3) | 391 (39.4) | 488 (49.2) | 41 (4.1) | 0.003 |
Breast cancer | 480 (7.4) | 44 (9.2) | 216 (45.0) | 202 (42.1) | 18 (3.8) | 0.15 |
Quartiles of average VM per 15-s epoch (adherent days only) | ||||||
---|---|---|---|---|---|---|
Total | <70.7 | 70.7–<95.2 | 95.2–<126.0 | ≥126.0 |
p-value | |
Age group, years, n (%) | ||||||
63–69 | 627 (10.2) | 67 (10.7) | 98 (15.6) | 169 (27.0) | 293 (46.7) | <0.001 |
70–79 | 2448 (40.0) | 417 (17.0) | 600 (24.5) | 664 (27.1) | 767 (31.3) | |
80–89 | 2794 (45.6) | 908 (32.5) | 767 (27.5) | 663 (23.7) | 456 (16.3) | |
90+ | 257 (4.2) | 139 (54.1) | 67 (26.1) | 36 (14.0) | 15 (5.8) | |
Race/Ethnicity, n (%) | ||||||
Non-Hispanic White | 3046 (49.7) | 911 (29.9) | 779 (25.6) | 726 (23.8) | 630 (20.7) | <0.001 |
Non-Hispanic Black | 2047 (33.4) | 489 (23.9) | 541 (26.4) | 519 (25.4) | 498 (24.3) | |
Hispanic/Latina | 1033 (16.9) | 131 (12.7) | 212 (20.5) | 287 (27.8) | 403 (39.0) | |
Education, n (%) | ||||||
High School or less | 1237 (20.3) | 311 (25.1) | 315 (25.5) | 307 (24.8) | 304 (24.6) | 0.05 |
Some College | 2349 (38.6) | 620 (26.4) | 610 (26.0) | 555 (23.6) | 564 (24.0) | |
College Graduate or more | 2499 (41.1) | 590 (23.6) | 593 (23.7) | 655 (26.2) | 661 (26.5) | |
Current Smoker, n (%) | 159 (2.9) | 58 (36.5) | 38 (23.9) | 38 (23.9) | 25 (15.7) | 0.001 |
Alcohol Use, n (%) | ||||||
Non-drinker | 2089 (37.4) | 589 (28.2) | 571 (27.3) | 500 (23.9) | 429 (20.5) | <0.001 |
< 1 drink per week | 1912 (34.2) | 477 (25.0) | 479 (25.1) | 490 (25.6) | 466 (24.4) | |
≥ 1 drink per week | 1589 (28.4) | 290 (18.3) | 342 (21.5) | 429 (27.0) | 528 (33.2) | |
Excellent or Very Good Self-Rated Health, n (%) | 2852 (51.3) | 469 (16.4) | 665 (23.3) | 781 (27.4) | 937 (32.9) | <0.001 |
RAND SF-36 Physical Function Score, mean (SD) | 68.2 (25.8) | 50.4 (26.5) | 66.0 (24.7) | 73.4 (22.0) | 82.0 (18.6) | <0.001 |
Depressive Symptoms Score, mean (SD) | 0.03 (0.11) | 0.03 (0.12) | 0.03 (0.10) | 0.02 (0.10) | 0.02 (0.10) | 0.31 |
Self-Reported Physical Activity, MET-hrs/week, mean (SD) | 12.0 (14.1) | 6.3 (9.1) | 9.9 (11.1) | 13.3 (13.9) | 18.4 (17.6) | <0.001 |
CHAMPS Expenditure, MET-hrs/week, mean (SD) | 29.4 (26.9) | 18.8 (18.1) | 25.0 (20.7) | 32.4 (27.4) | 41.0 (33.3) | <0.001 |
CARDIA Scale, sedentary hours/week, mean (SD) | 56.3 (22.6) | 63.2 (23.0) | 58.4 (22.6) | 54.6 (21.8) | 49.6 (20.7) | <0.001 |
Falls in past 12 months, n (%) | ||||||
None | 4256 (69.5) | 1010 (23.7) | 1065 (25.0) | 1068 (25.1) | 1113 (26.2) | <0.001 |
One time | 1195 (19.5) | 298 (24.9) | 307 (25.7) | 307 (25.7) | 283 (23.7) | |
Two or more times | 675 (11.0) | 223 (33.0) | 160 (23.7) | 157 (23.3) | 135 (20.0) | |
Falls Efficacy Score, mean (SD) | 10.7 (4.1) | 12.6 (4.9) | 10.6 (3.8) | 10.2 (3.7) | 9.4 (3.3) | <0.001 |
Short Physical Performance Battery score, mean (SD) | 8.2 (2.5) | 6.8 (2.7) | 8.1 (2.4) | 8.7 (2.2) | 9.3 (2.1) | <0.001 |
Systolic Blood Pressure, mean (SD) | 125.7 (14.3) | 128.1 (15.2) | 126.4 (14.5) | 125.2 (14.0) | 123.2 (13.2) | <0.001 |
Diastolic Blood Pressure, mean (SD) | 72.5 (8.8) | 73.1 (9.5) | 72.6 (8.9) | 72.3 (8.6) | 72.1 (8.0) | 0.03 |
Waist, inches, mean (SD) | 35.4 (5.5) | 37.4 (5.9) | 36.0 (5.2) | 34.9 (5.2) | 33.3 (4.6) | <0.001 |
Weight, lbs, mean (SD) | 157.9 (34.1) | 166.9 (38.2) | 160.3 (34.8) | 155.9 (31.6) | 148.8 (28.5) | <0.001 |
Body Mass Index, kg/m2, mean (SD) | 28.1 (5.7) | 29.7 (6.3) | 28.7 (5.7) | 27.7 (5.5) | 26.4 (4.8) | <0.001 |
Body Mass Index Categories, n (%) | ||||||
< 25 kg/m2
| 1868 (32.5) | 328 (17.6) | 400 (21.4) | 495 (26.5) | 645 (34.5) | <0.001 |
25–<30 kg/m2
| 2076 (36.2) | 474 (22.8) | 524 (25.2) | 562 (27.1) | 516 (24.9) | |
≥ 30 kg/m2
| 1796 (31.3) | 597 (33.2) | 516 (28.7) | 395 (22.0) | 288 (16.0) | |
Medical History | ||||||
Stroke | 427 (7.0) | 164 (38.4) | 123 (28.8) | 79 (18.5) | 61 (14.3) | <0.001 |
Congestive Heart Failure | 124 (2.0) | 67 (54.0) | 26 (21.0) | 22 (17.7) | 9 (7.3) | <0.001 |
Total CVD | 1234 (20.1) | 441 (35.7) | 329 (26.7) | 273 (22.1) | 191 (15.5) | <0.001 |
Hip fracture | 177 (2.9) | 72 (40.7) | 49 (27.7) | 39 (22.0) | 17 (9.6) | <0.001 |
Any clinical fracture | 2060 (33.6) | 580 (28.2) | 508 (24.7) | 508 (24.7) | 464 (22.5) | <0.001 |
Diabetes | 1928 (31.5) | 603 (31.3) | 529 (27.4) | 442 (22.9) | 354 (18.4) | <0.001 |
Osteoarthritis | 3748 (61.2) | 974 (26.0) | 960 (25.6) | 930 (24.8) | 884 (23.6) | 0.005 |
Invasive cancer | 942 (15.4) | 292 (31.0) | 252 (26.8) | 220 (23.4) | 178 (18.9) | <0.001 |
Breast cancer | 457 (7.5) | 138 (30.2) | 124 (27.1) | 99 (21.7) | 96 (21.0) | 0.009 |