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Midlife Fitness Associated With Compression of Morbidity in Late Life

It is widely accepted that exercise is beneficial to health, yet national survey data indicate that 36.2% of American adults do not engage in any leisure-time physical activity. Further, numerous cross-sectional and longitudinal studies have quantified relationships between physical activity and various outcomes including diabetes, cardiovascular disease, and mortality, with most showing an inverse association between fitness and these unfavorable outcomes. An interesting question that has not been investigated is the association between fitness level in midlife and nonfatal outcomes that occur at older ages and how this dynamic relates to the onset of morbidity in old age. New data from Willis et al. address these questions in a cohort of >18,000 men and women who were examined between 1970 and 2009 as part of the Cooper Center Longitudinal Study (CCLS). Participants in this intriguing study turned 65 between 1999 and 2009, and their Medicare claims data were merged with fitness and other clinical data that were collected during in-person CCLS examinations. The combination of CCLS and Medicare claims data allowed investigators to quantify the association between midlife fitness, measured by both metabolic equivalents (METs) and fitness quintiles, and the burden of eight nonfatal chronic conditions that are common in old age. These conditions included congestive heart failure, ischemic heart disease, stroke, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer's disease, and colon or lung cancer. The data showed that in both men and women, higher quintile of midlife fitness was associated with markedly lower rates of chronic conditions in old age. In women, the rates of chronic conditions were 20.1, 16.6, 14.3, 12.3, and 11.4 per 100 person-years for the 1st to 5th quintile of midlife fitness, respectively. Although the overall chronic disease burden in older age was higher across the board in men, an identical pattern was …

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This Article

  1. doi: 10.2337/db12-dd11 Diabetes vol. 61 no. 11 3034-3035
  1. Free via Open Access: OA