{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:16:23Z","timestamp":1792818983805,"version":"4.5.0"},"reference-count":20,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2023,9,12]]},"abstract":"\n Importance<\/jats:title>\n Sedentary behavior is associated with cardiometabolic disease and mortality, but its association with dementia is unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate whether accelerometer-assessed sedentary behavior is associated with incident dementia.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n A retrospective study of prospectively collected data from the UK Biobank including 49\u202f841 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.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n 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\u2013based analysis of 1 week of wrist-worn accelerometer data.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 49\u202f841 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,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) for 10 hours\/d, 1.63 (95% CI, 1.35-1.97,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) for 12 hours\/d, and 3.21 (95% CI, 2.05-5.04,\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) for 15 hours\/d. The adjusted incidence rate of dementia per 1000 person-years was 7.49 (95% CI, 7.48-7.49) for 9.27 hours\/d of sedentary behavior, 8.06 (95% CI, 7.76-8.36) for 10 hours\/d, 12.00 (95% CI, 10.00-14.36) for 12 hours\/d, and 22.74 (95% CI, 14.92-34.11) for 15 hours\/d. Mean daily sedentary bout length (HR, 1.53 [95% CI, 1.03-2.27],\n P<\/jats:italic>\n \u2009=\u2009.04 and 0.65 [95% CI, 0.04-1.57] more dementia cases per 1000 person-years for a 1-hour increase from the mean of 0.48 hours) and maximum daily sedentary bout length (HR, 1.15 [95% CI, 1.02-1.31],\n P<\/jats:italic>\n \u2009=\u2009.02 and 0.19 [95% CI, 0.02-0.38] more dementia cases per 1000 person-years for a 1-hour increase from the mean of 1.95 hours) were significantly associated with higher risk of incident dementia. The number of sedentary bouts per day was not associated with higher risk of incident dementia (HR, 1.00 [95% CI, 0.99-1.01],\n P<\/jats:italic>\n \u2009=\u2009.89). In the sensitivity analyses, after adjustment for time spent in sedentary behavior, the mean daily sedentary bout length and the maximum daily sedentary bout length were no longer significantly associated with incident dementia.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2023.15231","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T11:02:26Z","timestamp":1694516546000},"page":"934","source":"Crossref","is-referenced-by-count":157,"title":["Sedentary Behavior and Incident Dementia Among Older Adults"],"prefix":"10.1001","volume":"330","author":[{"given":"David A.","family":"Raichlen","sequence":"first","affiliation":[{"name":"Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles"},{"name":"Department of Anthropology, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H.","family":"Aslan","sequence":"additional","affiliation":[{"name":"Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Katherine","family":"Sayre","sequence":"additional","affiliation":[{"name":"Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradyumna K.","family":"Bharadwaj","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Arizona, Tucson"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Ally","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Arizona, Tucson"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Maltagliati","sequence":"additional","affiliation":[{"name":"Universite of Grenoble Alpes, SENS, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark H. C.","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rand R.","family":"Wilcox","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann C.","family":"Klimentidis","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson"},{"name":"BIO5 Institute, University of Arizona, Tucson"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene E.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Arizona, Tucson"},{"name":"BIO5 Institute, University of Arizona, Tucson"},{"name":"Evelyn F. McKnight Brain Institute, University of Arizona, Tucson"},{"name":"Department of Psychiatry, University of Arizona, Tucson"},{"name":"Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"12","key":"joi230096r1","doi-asserted-by":"publisher","first-page":"2512","DOI":"10.1249\/MSS.0000000000002751","article-title":"Sedentary behavior in US adults: fall 2019.","volume":"53","author":"Matthews","year":"2021","journal-title":"Med Sci Sports Exerc"},{"issue":"8","key":"joi230096r2","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1161\/CIRCULATIONAHA.118.035312","article-title":"Sedentary behavior and cardiovascular disease in older women: the Objective Physical Activity and Cardiovascular Health (OPACH) study.","volume":"139","author":"Bellettiere","year":"2019","journal-title":"Circulation"},{"key":"joi230096r3","doi-asserted-by":"publisher","first-page":"l4570","DOI":"10.1136\/bmj.l4570","article-title":"Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis.","volume":"366","author":"Ekelund","year":"2019","journal-title":"BMJ"},{"issue":"3","key":"joi230096r4","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1093\/aje\/kwx273","article-title":"Associations between sedentary behaviors and cognitive function: cross-sectional and prospective findings from the UK Biobank.","volume":"187","author":"Bakrania","year":"2018","journal-title":"Am J Epidemiol"},{"issue":"4","key":"joi230096r5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195549","article-title":"Sedentary behavior associated with reduced medial temporal lobe thickness in middle-aged and older adults.","volume":"13","author":"Siddarth","year":"2018","journal-title":"PLoS One"},{"issue":"1","key":"joi230096r6","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s12966-017-0525-8","article-title":"Sedentary Behavior Research Network (SBRN)\u2013terminology consensus project process and outcome.","volume":"14","author":"Tremblay","year":"2017","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"35","key":"joi230096r7","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2206931119","article-title":"Leisure-time sedentary behaviors are differentially associated with all-cause dementia regardless of engagement in physical activity.","volume":"119","author":"Raichlen","year":"2022","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"7","key":"joi230096r8","doi-asserted-by":"publisher","first-page":"3041","DOI":"10.1002\/alz.v19.7","article-title":"Accelerometer-measured physical activity and sitting with incident mild cognitive impairment or probable dementia among older women.","volume":"19","author":"Nguyen","year":"2023","journal-title":"Alzheimers Dement"},{"issue":"3","key":"joi230096r9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001779","article-title":"UK Biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age.","volume":"12","author":"Sudlow","year":"2015","journal-title":"PLoS Med"},{"issue":"2","key":"joi230096r10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0169649","article-title":"Large scale population assessment of physical activity using wrist worn accelerometers: the UK Biobank study.","volume":"12","author":"Doherty","year":"2017","journal-title":"PLoS One"},{"issue":"18","key":"joi230096r11","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1136\/bjsports-2021-104050","article-title":"Reallocation of time between device-measured movement behaviours and risk of incident cardiovascular disease.","volume":"56","author":"Walmsley","year":"2021","journal-title":"Br J Sports Med"},{"issue":"8","key":"joi230096r12","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1249\/MSS.0b013e31821ece12","article-title":"2011 Compendium of Physical Activities: a second update of codes and MET values.","volume":"43","author":"Ainsworth","year":"2011","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"joi230096r13","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1001\/jama.2019.9879","article-title":"Association of lifestyle and genetic risk with incidence of dementia.","volume":"322","author":"Lourida","year":"2019","journal-title":"JAMA"},{"issue":"1","key":"joi230096r14","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1093\/biomet\/69.1.239","article-title":"Partial residuals for the proportional hazards regression model.","volume":"69","author":"Schoenfeld","year":"1982","journal-title":"Biometrika"},{"issue":"4","key":"joi230096r15","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1093\/gerona\/glac023","article-title":"Objectively measured total sedentary time and pattern of sedentary accumulation in older adults: associations with incident cardiovascular disease and all-cause mortality.","volume":"77","author":"Yerramalla","year":"2022","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"joi230096r17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"MICE: multivariate imputation by chained equations in R.","volume":"45","author":"Van Buuren","year":"2011","journal-title":"J Stat Softw"},{"issue":"10","key":"joi230096r18","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1001\/jamaneurol.2022.2672","article-title":"Association of daily step count and intensity with incident dementia in 78 430 adults living in the UK.","volume":"79","author":"Del Pozo Cruz","year":"2022","journal-title":"JAMA Neurol"},{"issue":"10","key":"joi230096r19","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1001\/jamaneurol.2019.1879","article-title":"Associations of physical activity and \u00df-amyloid with longitudinal cognition and neurodegeneration in clinically normal older adults.","volume":"76","author":"Rabin","year":"2019","journal-title":"JAMA Neurol"},{"issue":"10","key":"joi230096r20","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1136\/bjsports-2015-095551","article-title":"What is the association between sedentary behaviour and cognitive function? a systematic review.","volume":"51","author":"Falck","year":"2017","journal-title":"Br J Sports Med"},{"key":"joi230096r16","volume-title":"Introduction to Robust Estimation and Hypothesis Testing","author":"Wilcox","year":"2022","edition":"5th ed"}],"container-title":["JAMA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/articlepdf\/2809418\/jama_raichlen_2023_oi_230096_1694462892.28495.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T11:02:29Z","timestamp":1694516549000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2809418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,12]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,9,12]]}},"URL":"https:\/\/doi.org\/10.1001\/jama.2023.15231","relation":{},"ISSN":["0098-7484"],"issn-type":[{"value":"0098-7484","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9,12]]}}}