The association between adherence to the Canadian 24-hour Movement Guidelines and Frailty, and mortality: A cross sectional and prospective analysis of the National Health and Nutrition Examination Survey

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University of New Brunswick


The Canadian 24-Hour Movement Guidelines (24H-MG) give recommendations for physical activity, sedentary time, and sleep. While following the 24H-MG prevents many chronic conditions, the association between meeting these guidelines and frailty, or mortality when considering frailty levels, is unknown. Therefore, the study objective was to investigate the cross sectional and prospective association between adherence to the 24H-MG and frailty and mortality. Participants (n=2739) from the National Health and Nutrition Examination Survey were included. Linear and cox regressions adjusted for known co-variates quantified the relationship between exposure and primary outcome variables. The results show that increased adherence to the 24H-MG is associated with lower frailty levels in adults 20-64 and 65+, with recreational screen time and MVPA showing the strongest association. No prospective association was observed between adherence to the complete 24H-MG and mortality, but adherence to the MVPA guideline in the 65+ age group was associated with lower mortality.