Synergistic impact of rest-activity circadian rhythms and physical activity on all-cause and cardiovascular mortality

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ID: 314601
2026
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Abstract
Abstract Background This study investigated the independent and joint associations of rest-activity circadian rhythms (RACRs) and physical activity (PA) with all-cause and cardiovascular mortality, and explored the potential role of accelerated biological aging. Methods We included 6621 adults from NHANES 2011-2014. RACR parameters were derived from wrist-worn ActiGraph GT3X+ data. Accelerated biological aging was assessed using Phenotypic Age Acceleration (PhenoAgeAccel) and Biological Age Acceleration (BioAgeAccel). Cox proportional hazards models were applied to investigate the associations of RACRs and PA with all-cause and cardiovascular mortality. Exploratory mediation analyses were used to explore the associations between accelerated biological aging, RACRs, and mortality risks. Results Over a median follow-up of 6.75 years, 518 all-cause deaths and 165 cardiovascular deaths were recorded. Compared with weak RACRs and inadequate PA, participants with strong RACRs and adequate PA had significantly lower risks of all-cause mortality (HR: 0.35, 95% CI: 0.24 to 0.51; P < 0.001) and cardiovascular mortality (HR: 0.25, 95% CI: 0.14 to 0.45; P < 0.001). In exploratory analyses, PhenoAgeAccel accounted for an estimated 13.55% (P < 0.001) and 21.67% (P = 0.002) of the associations between RACRs and all-cause and cardiovascular mortality, respectively, while BioAgeAccel accounted for an estimated 5.06% (P < 0.001) and 8.06% (P = 0.004). Conclusions Disrupted RACRs are associated with higher mortality risks that could be attenuated by adequate physical activity. Exploratory analyses suggest that the associations between RACRs and mortality may be mediated in part by accelerated biological aging, but additional studies are needed to test this hypothesis.
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Authors B Gu, Haoyu Zhang, Ming Yi, Si Jin, Keling Xiao, Sun L, Jinghao Sun, Hongyun Zhao, Ou Zhao, Y X, Hongyu Luo, Jing Li
Journal the journals of gerontology series a, biological sciences and medical sciences
Year 2026
DOI
10.1093/gerona/glag130
URL
https://doi.org/10.1093/gerona/glag130
Keywords Keywords not found

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