Background/Aims: Physical activity is a target for early and ongoing cerebrovascular disease prevention. However, relationships between trajectories of total activity and all comprising domains (leisure, transport, occupational, domestic) across the life course with risk of stroke has not been examined. This study aimed to determine associations between life course activity trajectories and subclinical risk factors for stroke in mid-adulthood.
Methods: Latent class growth mixture modelling was used to assess life course trajectories of total and domain-specific activity (n=2311) among participants of the Australian Childhood Determinants of Adult Health Study (four timepoints [ages 9-49y]; 1985 baseline). Relationships between activity trajectories and subclinical risk factors of carotid intima-media thickness (n=914) and carotid plaques (n=867) were analysed using log-binomial and multivariable regression, adjusting for covariates.
Results: ‘Consistently high’ leisure activity from childhood to adulthood was associated with reduced risk of plaques (RR=0.56; 95%CI=0.23-0.89) in mid-adulthood. ‘High-increasing’ school/occupational activity was associated with higher carotid intima-media thickness (β=0.06; 95%CI=0.01-0.11). No associations were observed with transport or domestic activity.
Conclusion: This study was the first to assess life course trajectories of total and domain-specific activity against sub-clinical cerebrovascular risk outcomes amongst a single cohort. Our findings suggest that transport and domestic activity contributes little to cerebrovascular risk, while maintaining high levels of life course leisure-time activity may reduce cerebrovascular risk in mid-adulthood. However, those with high school-based activity in childhood and occupational activity in adulthood relative to their peers may have elevated risk of stroke. These contrasting relationships suggest complex mechanisms of effect, warranting future examination.