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Health & Medicine for Senior Citizens

Fitness at Middle Age Leads to Lower Risk of Chronic Disease in Senior Years

Even study participants who died had fewer chronic ailments to the end

Aug. 27, 2012 - A new study declares that fitness in middle age points to less chronic health problems in later life. And, even those who died in old age, seemed to have less of these chronic ailments right up to the end. The study involved both senior men and women, older than 65, who were Medicare patients.

The study was published Online First by Archives of Internal Medicine, a JAMA Network publication. But, the findings came with a caution flag waved in a commentary by Diane E. Bild, M.D., M.P.H., of the National Heart, Lung and Blood Institute.

The research was by Benjamin L. Willis, M.D., M.P.H., of the Cooper Institute, Dallas, and colleagues. They examined the association between midlife fitness and chronic disease outcomes later in life by linking Medicare claims with participant data from the Cooper Center Longitudinal Study, a large group of individuals who were examined at the Cooper Clinic from 1970 to 2009.


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The study of 14,726 healthy men and 3,944 healthy women, with an average age of 49, when they entered the study, used eight chronic conditions (CCs) for the analysis: congestive heart failure, ischemic heart disease, stroke, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer disease, and colon or lung cancer.

“In the present study, higher fitness measured in midlife was strongly associated with a lower incidence of CCs decades later,” the authors note.

With a median follow-up of 26 years, the highest level of midlife fitness was associated with a lower incidence of CCs compared with the lowest midlife fitness in men 15.6 vs. 28.2 per 100 person-years and in women 11.4 vs. 20.1 per 100 person years, according to the study results. Age- and sex-specific quintiles of fitness were based on treadmill times.

Researchers suggest a moderate increase in fitness may mean a reduction in CCs in older age.

“For example, a 1- to 2-MET (metabolic equivalent) improvement in fitness resulting in promotion from the first to the second fitness quintile at age 50 years was associated with a 20 percent reduction in the incidence of CCs at ages 65 and older,” according to the study.

Among those participants who died, researchers note that higher midlife fitness appeared to be more strongly associated with a delay in the development of CCs than with survival.

“Compared with participants with lower midlife fitness, those with higher midlife fitness appeared to spend a greater proportion of their final five years of life with a lower burden of CCs,” the authors comment.

Dr. Bild, acknowledges in that in the commentary, Thriving of the Fittest, the researchers do provide “further evidence for physical fitness as a contributor to healthy aging and the compression of morbidity.”

Acknowledging that ‘fitness may be a key to healthy aging.’ Bild notes that “fitness is a function of both exercise and genetics.”

“Because genetics likely plays a role in longevity and certainly plays a role in disease avoidance, if some of the same genes are involved in longevity and fitness, they may serve as major confounders in the attractive interpretation that exercise leads to fitness, which leads to healthy aging,” Bild continues.

“Research on healthy aging is important for its insights into living longer, healthier and more active lives and, potentially, reducing health care costs. In addition to observational studies such as the present one, clinical trials are needed to establish definitively the benefits and risks of approaches that have been shown in observational studies to be associated with extending health and life,” Bild concludes.

 (Note: Dr. Willis disclosed financial compensation from Merck, as well as funding and grant support from other sources. The Cooper Institute is a 501(c)(3) nonprofit research institute and provided internal funding for this study.

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