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Fitness and the Prevention of Chronic Disease

Saturday, September 29, 2012 // Uncategorized

Midlife Fitness and the Development of Chronic Conditions in Later Life

Benjamin L. Willis, MD, MPH; Ang Gao, MS; David Leonard, PhD; Laura F. DeFina, MD; Jarett D. Berry, MD, MS
[+-] Author Affiliations

Author Affiliations: The Cooper Institute (Drs Willis and DeFina), Division of Cardiology, Department of Internal Medicine (Ms Gao and Dr Berry), and Department of Clinical Science, Division of Biostatistics (Dr Leonard), The University of Texas Southwestern Medical Center, Dallas.

 

Arch Intern Med. 2012;172(17):1-8. doi:10.1001/archinternmed.2012.3400.
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 HERE IS SOME ADDITIONAL INFORMATION THAT SUPPORTS THE BENEFITS OF EXERCISE.  IT MAY PREVENT THE DEVELOPMENT OF CHRONIC CONDITIONS.  IN ADDITION, IT APPEARS TO DECREASE  THE TIME THAT PEOPLE ARE DISABLED PRIOR TO DEATH. EXERCISE AND YOU MAY LIVE LONGER AND SPEND LESS TIME IN A NURSING HOME.
 
 
 
 
ABSTRACT

Background  The association between cardiorespiratory fitness (fitness) and mortality is well described. However, the association between midlife fitness and the development of nonfatal chronic conditions in older age has not been studied.

Methods  To examine the association between midlife fitness and chronic disease outcomes in later life, participant data from the Cooper Center Longitudinal Study were linked with Medicare claims. We studied 18 670 healthy participants (21.1% women; median age, 49 years) who survived to receive Medicare coverage from January 1, 1999, to December 31, 2009. Fitness estimated by Balke treadmill time was analyzed as a continuous variable (in metabolic equivalents [METs]) and according to age- and sex-specific quintiles. Eight common chronic conditions were defined using validated algorithms, and associations between midlife fitness and the number of conditions were assessed using a modified Cox proportional hazards model that stratified the at-risk population by the number of conditions while adjusting for age, body mass index, blood pressure, cholesterol and glucose levels, alcohol use, and smoking.

Results  After 120 780 person-years of Medicare exposure with a median follow-up of 26 years, the highest quintile of fitness (quintile 5) was associated with a lower incidence of chronic conditions compared with the lowest quintile (quintile 1) in men (15.6 [95% CI, 15.0-16.2] vs 28.2 [27.4-29.0] per 100 person-years) and women (11.4 [10.5-12.3] vs 20.1 [18.7 vs 21.6] per 100 person-years). After multivariate adjustment, higher fitness (in METs) was associated with a lower risk of developing chronic conditions in men (hazard ratio, 0.95 [95% CI, 0.94-0.96] per MET) and women (0.94 [0.91-0.96] per MET). Among decedents (2406 [12.9%]), higher fitness was associated with lower risk of developing chronic conditions relative to survival (compression hazard ratio, 0.90 [95% CI, 0.88-0.92] per MET), suggesting morbidity compression.

Conclusions  In this cohort of healthy middle-aged adults, fitness was significantly associated with a lower risk of developing chronic disease outcomes during 26 years of follow-up. These findings suggest that higher midlife fitness may be associated with the compression of morbidity in older age

 

Figure. Prevalence of selected chronic conditions in men and women by attained age (N = 18 670). Prevalence of chronic conditions at ages 70, 75, 80, and 85 years was determined by classifying all participants alive at these age thresholds according to the presence or absence of each of the 8 chronic conditions. The presence of a condition required that the earliest indication of the condition occurred before or at the attained age among survivors. Because some participants survived across multiple age thresholds and are represented in more than 1 age category, the numbers listed for the age groups total more than 18 670. ALZ indicates Alzheimer disease; CA, cancer of the colon or lung; CHF, congestive heart failure; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; DM, diabetes mellitus; and IHD, ischemic heart disease.

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