Leisure-Time Physical Activity Across Adult Life and Mortality

Study Questions:

Does an association exist between leisure-time physical activity (LTPA) life course patterns and mortality?

Methods:

This prospective cohort study used data from the 1995 to 1996 National Institutes of Health–AARP (formerly American Association of Retired Persons) Diet and Health Study baseline questionnaire that collected information on diet and some lifestyle factors. In 1996 and 1997, the participants were mailed a Risk-Factor Questionnaire, and received a follow-up questionnaire from 2004 to 2006. The primary focus of the study was to ascertain cancer incidence through a linkage of the cohort to state cancer registries and vital status through the SSA Death Master File and follow-up searches of the National Death Index Plus. Data analysis was conducted from March 2017 through February 2018. Data were analyzed for 315,059 adult AARP members living in six states: California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania, or two metropolitan areas (Atlanta or Detroit).

Results:

Of 315,059 participants, 183,451 (58.2%) were men, and the participants were 50-71 years of age at enrollment. Ten LTPA trajectories (categorized as maintaining, increasing, and decreasing LTPA across time) were identified, and 71,377 deaths due to all causes, 22,219 deaths due to cardiovascular disease (CVD), and 16,388 deaths due to cancer occurred. Compared with participants who were consistently inactive, maintaining higher amounts of LTPA was significantly associated with lower all-cause (hazard ratio [HR], 0.64), CVD-related (HR, 0.58), and cancer-related (HR, 0.86) mortality. Adults who were less active throughout most of the adult life course but increased LTPA in later adulthood (40-61 years of age) also had lower risk for all-cause (HR, 0.65), CVD-related (HR, 0.57), and cancer-related (HR, 0.84) mortality.

Conclusions:

Maintaining higher LTPA levels and increasing LTPA in later adulthood were associated with comparable low risk of mortality, suggesting that mid-life is not too late to start physical activity. Inactive adults may be encouraged to be more active, whereas young adults who are already active may strive to maintain their activity level as they get older.

Perspective:

This study is unique in that it is the first to provide data on life-long activity from adolescence to “later life,” and all-cause and cause-specific mortality from a cohort that represented the US population. The results are not surprising considering the positive biologic effects of exercise on CV risk factors and the association between atherosclerosis and cancer.

Clinical Topics: Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Prevention, Diet, Exercise

Keywords: Atherosclerosis, Cardiovascular Diseases, Diet, Exercise, Geriatrics, Leisure Activities, Life Style, Neoplasms, Primary Prevention, Risk Factors


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