Abstract WE433: Prospective Associations of Physical Activity and Sedentary Behaviors on Reduced Cardiovascular Disease Risk in Older Women with Diabetes: The OPACH Study

Background: This study tested the hypothesized significant associations of physical activity (PA) and sedentary behavior (SB) with lower risk of incident CVD among older women with diabetes. Methods: From 2012-2014, older women (n=1,228; M=77.9yrs±6.5; 43%Black, 18%Hispanic) with diabetes free of prior CVD from the Women’s Health Initiative Objective Physical Activity and Cardiovascular Health (OPACH) Study wore an ActiGraph GT3x+ for a week and were followed through February 2025 for incident major CVD (i.e., myocardial infarction, heart failure, stroke, or death attributable to any CVD). Covariate-adjusted cox models estimated HRs and 95%CI for total PA, light PA (LPA), moderate-to-vigorous intensity PA (MVPA), steps/day, total sitting time, and mean sitting bout duration (MSBD) with incident CVD. Stratified analyses were conducted by age and Reynold’s Risk Score. Results: HRs (95%CI; P-trend) for 1-SD increments (min/day) were 0.77 (0.66-0.90; 0.004) for total PA (SD=85.8), 0.80 (0.69-0.92; 0.02) for LPA (SD=70.2), 0.82 (0.7-0.97) for MVPA (SD=27.9), 0.76 (0.63-0.91) for steps/day (SD=1718.8), 1.10 (0.95-1.29; 0.09) for total sitting time (SD=97.5), and 1.13 (0.99-1.29; 0.10) for MSBD (SD=5.8). PA and SB associations were mostly linear where most of the data was (Figure 1). In stratified analyses, associations for LPA with CVD were stronger for women who were older, 0.65 (0.50-0.83) vs 0.85 (0.59-1.24) and had a higher Reynold’s Risk Score, 0.63 (0.48-0.83) vs 0.98 (0.69-1.40). Similar trends to LPA were observed for total PA, MVPA, and steps/day with age and Reynold’s Risk Score. Conclusions: Higher PA, including LPA, is associated with lower CVD risk, supporting efforts to promote PA among older women with diabetes.