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Physical Activity Change and CV Health in Older Adults
Quick Takes
- Decrease in frequency of moderate to vigorous physical activity (MVPA) was associated with a significantly elevated risk of CVD events as compared to consistently engaging in >5 times of MVPA per week in older adults.
- Increase in frequency of MVPA per week regardless of disabilities and chronic conditions was associated with a significant risk reduction of CVD among those who were physically inactive.
- Clinicians should encourage all patients and especially older adults to increase or maintain frequency of MVPA regardless of disabilities or chronic conditions.
Study Questions:
What is the association of changes in moderate to vigorous physical activity (MVPA) level and cardiovascular disease (CVD) in older adults?
Methods:
The investigators identified >1.1 million subjects in a nationwide cohort study of older adults aged ≥60 years, without previous history of CVD at baseline, who underwent two consecutive national health screenings from 2009 to 2012. The authors prospectively assessed the risk of CVD that occurred between 2013 and 2016, according to changes in frequency of MVPA by initial MVPA status. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD outcomes were calculated from adjusting the following variables in the Cox regression model: age, sex, place of residence, insurance premium, insurance type, body mass index, systolic blood pressure, total cholesterol, fasting serum glucose, cigarette smoking, alcohol consumption, medication use (aspirin, antihypertensive medication, antidiabetic medication, statin, nonsteroidal anti-inflammatory drugs), Charlson comorbidity index, and family history of CVD.
Results:
Compared to those who were continuously physically inactive, those who increased their frequency of MVPA from physically inactive to 1–2 times per week (0.7/1,000 person-years decrease in incidence rate [IR]; aHR, 0.95; 95% CI, 0.92–0.99), 3–4 times per week (1.5/1,000 person-years decrease in IR; aHR, 0.89; 95% CI, 0.84–0.94), and ≥5 times per week (0.4/1,000 person-years decrease in IR; aHR, 0.91; 95% CI, 0.85–0.97) had a significantly reduced risk for total CVD (p for trend < 0.001). Older adults who became physically inactive from engaging in more than 1–2 times of MVPA per week had a higher CVD risk compared to those who maintained their frequency of MVPA.
Conclusions:
Among older adults, engaging in higher frequency of MVPA or maintaining MVPA level was associated with reduced risk of CVD.
Perspective:
This population-based cohort study from the Republic of Korea reports that the older adults with insufficient physical activity who increased frequency of MVPA to >3–4 times per week had a significantly lower risk of CVD events as compared to those who were continuously physically inactive, and this association was consistent among those with disabilities and chronic conditions. Furthermore, decrease in frequency of MVPA was associated with a significantly elevated risk of CVD events as compared to consistently engaging in >5 times of MVPA per week in older adults. These data suggest a need to encourage higher frequency of MVPA among physically inactive older adults and maintaining frequency of MVPA among those who are already physically active for substantial and tangible CVD risk reduction.
Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Prevention, Sports and Exercise Cardiology, Exercise
Keywords: Antihypertensive Agents, Blood Pressure, Body Mass Index, Cardiovascular Diseases, Exercise, Geriatrics, Physical Fitness, Primary Prevention, Risk Reduction Behavior, Sedentary Behavior
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