{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:05:17Z","timestamp":1775538317773,"version":"3.50.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Functional decline is a major challenge in aging, particularly for those with a history of cerebrovascular events. Yet, prior research relies heavily on self-reported measures. The impact of objective physical activity patterns, particularly sedentary accumulation, on long-term functional prognosis remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Using the National Health and Aging Trends Study (NHATS), we analyzed 480 community-dwelling older adults (weighted\n                      <jats:italic>N<\/jats:italic>\n                      \u202f=\u202f1.9 million). Group-Based Trajectory Modeling (GBTM) was applied to 7\u202fyears of follow-up data to identify trajectories of ADL disability. Wrist-worn accelerometry captured objective activity profiles. Weighted logistic regression and restricted cubic splines assessed associations between activity metrics and adverse trajectories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three distinct trajectories were identified: \u201cRobust,\u201d \u201cProgressive Decline,\u201d and \u201cPersistent Severe Disability.\u201d Stroke survivors were disproportionately represented in the severe disability group compared to controls (35% vs. 10%). Although stroke survivors constituted a small proportion of the unweighted sample, they exhibited a profoundly amplified vulnerability to sedentary behaviors. Average sedentary bout length emerged as a core risk factor independent of total activity volume (aOR 1.15 per 10-min increase). Total activity exhibited an \u201cL-shaped\u201d protective association, while sedentary time showed a \u201cJ-shaped\u201d risk threshold (&amp;gt;700\u202fmin\/day). Interaction analysis revealed that frequent interruptions of sedentary time could partially offset the risks associated with low total activity volume.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Beyond total activity volume, continuous sedentary patterns are critical biomarkers of functional decline in older adults. Stroke survivors represent a highly vulnerable subpopulation where clinical rehabilitation strategies should prioritize \u2018sedentary interruption\u2019.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1792601","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:21:48Z","timestamp":1775535708000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Objective physical activity characteristics and long-term functional disability trajectories in community-dwelling older adults: the amplifying risk of stroke"],"prefix":"10.3389","volume":"14","author":[{"given":"Jianhui","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Emergency, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zanzhi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Emergency, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaoquan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Emergency, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Research and Development, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinliang","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Emergency, Ganzhou People\u2019s Hospital","place":["Ganzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Emergency, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Emergency, Ganzhou People\u2019s Hospital","place":["Ganzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Emergency, Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]},{"name":"Department of Emergency, Ganzhou People\u2019s Hospital","place":["Ganzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1111\/jgs.16274","article-title":"Impact of baseline fatigue on a physical activity intervention to prevent mobility disability","volume":"68","author":"Glynn","year":"2020","journal-title":"J Am Geriatr Soc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"13400","DOI":"10.1038\/s41598-025-97668-y","article-title":"Factors related to sex differences in long-term functional decline after acute ischemic stroke","volume":"15","author":"Irie","year":"2025","journal-title":"Sci Rep"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e364","DOI":"10.1161\/str.0000000000000375","article-title":"2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association\/American Stroke Association","volume":"52","author":"Kleindorfer","year":"2021","journal-title":"Stroke"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1161\/str.0000000000000098","article-title":"Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"47","author":"Winstein","year":"2016","journal-title":"Stroke"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1080\/10749357.2024.2333191","article-title":"Cardiorespiratory fitness, physical activity, and fatigue three months after first-ever ischemic stroke. 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