Ageing, Physical Activity and Mortality
Ageing, Physical Activity and Mortality
Background Physical activity (PA) is inversely associated with mortality in the general population. We wanted to quantify the association of self-reported PA with mortality from all causes, ischaemic heart disease (IHD) and stroke, and compare it with other known risk factors in different age segments.
Methods The Bergen Clinical Blood Pressure Survey examined a sample of 6811 Norwegian men and women in 1965–71 with follow-up until 2005–07. Cox proportional hazard regression ratio (HR) and population attributable fraction (PAF) were calculated for the old (>65), middle-aged (45–64) and young adults (22–44), respectively. We minimized confounding and bias by progressive comprehensive adjustments and subgroup-analyses (excluding early follow-up deaths, participants with self-reported disease and participants with changes in their PA-level prior baseline due to disease).
Results The HR [95% confidence interval (CI)] associated with a high PA-level was 0.63(0.56–0.71), 0.66(0.52–0.83) and 0.66(0.47–0.93) for mortality from all causes, IHD and stroke, respectively (reference: no participation in any of the listed activities, adjusted for age and gender). PAF (95% CI) of no/low activity (reference: any activity) was consistent across all age groups, varying from 7.3% (3.4–11.4) in the young adults to 9.1% (3.6–15.3) in the old. PAF of smoking and high s-cholesterol declined with increasing age [smoking from 19.9% (15.3–24.7) to 1.5% (−1.3 to 6.2) and s-cholesterol from 11.5% (5.6–17.5) to −9.5% (−18.1 to −0.7)], whereas PAF of hypertension increased from 5.3% (2.1–9.1) to 18.9% (8.3–28.4).
Conclusion The relative importance of traditional risk factors varies between the age groups, but physical activity is a major health promoting factor across all age segments and should be encouraged particularly in an ageing population.
Sedentary living has assumed epidemic proportions in the industrialized world and physical activity (PA) is one of the most important modifiable factors that determine the risk of chronic morbidity and high mortality in the population in general. The beneficial effect of PA on longevity and the disease-specific risks such as ischaemic heart disease (IHD), stroke and cancer has been studied since the 1950s in the adult and middle-aged population, but to a lesser extent in the old. For older adults, evidence indicates that being physically active is associated with increased longevity, higher levels of functional health, lower risk of falling, better cognitive function and increased social integration. Men have been studied more extensively than women, younger age ranges more than older ones, and external validity, follow-up time and response rates vary greatly in earlier research work. We are aware of only one previous population-based study which includes all adult age groups of both genders and with a follow-up period of more than 20 years. A major question regarding this amendable risk factor is to what extent PA has an effect on longevity beyond the recognized mediators of blood pressure, lipid profile and body mass. In addition, there arises the question whether this effect is valid for both genders and all age groups.
The inverse association between physical activity and death from any cause has previously been reported to be similar in magnitude to the effect of hypertension, hypercholesterolemia and smoking alone. However, the relative importance of the different risk factors may vary between the age groups.
In our study, we have an extensive follow-up time, a considerable number of old participants and a vast collection of potential confounders for adjustments. In addition, we have had the possibility to minimize confounding from reversed causation.
Thus, the aims of this study are:
Abstract and Introduction
Abstract
Background Physical activity (PA) is inversely associated with mortality in the general population. We wanted to quantify the association of self-reported PA with mortality from all causes, ischaemic heart disease (IHD) and stroke, and compare it with other known risk factors in different age segments.
Methods The Bergen Clinical Blood Pressure Survey examined a sample of 6811 Norwegian men and women in 1965–71 with follow-up until 2005–07. Cox proportional hazard regression ratio (HR) and population attributable fraction (PAF) were calculated for the old (>65), middle-aged (45–64) and young adults (22–44), respectively. We minimized confounding and bias by progressive comprehensive adjustments and subgroup-analyses (excluding early follow-up deaths, participants with self-reported disease and participants with changes in their PA-level prior baseline due to disease).
Results The HR [95% confidence interval (CI)] associated with a high PA-level was 0.63(0.56–0.71), 0.66(0.52–0.83) and 0.66(0.47–0.93) for mortality from all causes, IHD and stroke, respectively (reference: no participation in any of the listed activities, adjusted for age and gender). PAF (95% CI) of no/low activity (reference: any activity) was consistent across all age groups, varying from 7.3% (3.4–11.4) in the young adults to 9.1% (3.6–15.3) in the old. PAF of smoking and high s-cholesterol declined with increasing age [smoking from 19.9% (15.3–24.7) to 1.5% (−1.3 to 6.2) and s-cholesterol from 11.5% (5.6–17.5) to −9.5% (−18.1 to −0.7)], whereas PAF of hypertension increased from 5.3% (2.1–9.1) to 18.9% (8.3–28.4).
Conclusion The relative importance of traditional risk factors varies between the age groups, but physical activity is a major health promoting factor across all age segments and should be encouraged particularly in an ageing population.
Introduction
Sedentary living has assumed epidemic proportions in the industrialized world and physical activity (PA) is one of the most important modifiable factors that determine the risk of chronic morbidity and high mortality in the population in general. The beneficial effect of PA on longevity and the disease-specific risks such as ischaemic heart disease (IHD), stroke and cancer has been studied since the 1950s in the adult and middle-aged population, but to a lesser extent in the old. For older adults, evidence indicates that being physically active is associated with increased longevity, higher levels of functional health, lower risk of falling, better cognitive function and increased social integration. Men have been studied more extensively than women, younger age ranges more than older ones, and external validity, follow-up time and response rates vary greatly in earlier research work. We are aware of only one previous population-based study which includes all adult age groups of both genders and with a follow-up period of more than 20 years. A major question regarding this amendable risk factor is to what extent PA has an effect on longevity beyond the recognized mediators of blood pressure, lipid profile and body mass. In addition, there arises the question whether this effect is valid for both genders and all age groups.
The inverse association between physical activity and death from any cause has previously been reported to be similar in magnitude to the effect of hypertension, hypercholesterolemia and smoking alone. However, the relative importance of the different risk factors may vary between the age groups.
In our study, we have an extensive follow-up time, a considerable number of old participants and a vast collection of potential confounders for adjustments. In addition, we have had the possibility to minimize confounding from reversed causation.
Thus, the aims of this study are:
To explore the long-term associations between PA and mortality from any cause, IHD and stroke.
To study and compare the effect of PA with other established risk factors across different age groups at baseline.
Source...