Sociodemographic and lifestyle correlates of accelerometer-measured 24-hour physical behavior patterns: a cross-sectional analysis of the ELSA-Brasil cohort

Abstract

Physical activity, sedentary behavior, and sleep comprise an integrated 24-hour movement continuum that may influence health outcomes. While these behaviors have been studied separately, limited evidence exists on their combined patterns and related sociodemographic and lifestyle factors in middle-income countries like Brazil. The objective was to evaluate associations between sociodemographic and lifestyle correlates and accelerometer-measured 24-hour physical behavior patterns among Brazilian middle-aged and older adults. This cross-sectional analysis included 9,520 adults (mean age 59.2 ± 8.6 years) from the third wave of the ELSA-Brasil cohort study. Physical activity, sedentary behavior, and sleep were objectively measured using triaxial hip-worn accelerometers for seven consecutive days. Behavioral clusters were defined according to daily time spent in physical activity, sedentary behavior, and sleep using Partitioning Around Medoids cluster analysis. Sociodemographic and lifestyle factors were assessed via standardized questionnaires. Multinomial logistic regression models evaluated associations between correlates and behavioral clusters, with Cluster 3 as the reference category. Three clusters were identified: 1 (lower physical activity, higher sedentary behavior, shorter sleep), 2 (intermediate physical activity, intermediate sedentary behavior, intermediate sleep), and 3 (higher physical activity, lower sedentary behavior, longer sleep). Compared with Cluster 3, participants in Cluster 1 were more likely to be male, to have a higher body mass index, to have higher educational attainment, and to have a high income. Similar but weaker associations were observed for Cluster 2. Distinct 24-hour physical behavior patterns among Brazilian adults were associated with sociodemographic and lifestyle factors. These cross-sectional findings emphasize the need for targeted public health strategies promoting healthier 24-hour behavior profiles.