A report in the September issue of Archives of Internal Medicine (one of the JAMA/Archives journals) shows that older adults who maintain or begin any type of physical activity appear to live longer and have a lower risk of disability.

In the article, the authors write as background information: “Physical activity is a modifiable behavior associated with health, functional status and longevity, and encouraging a physically active lifestyle has become an accepted public health goal.” However, most of earlier research on the benefits of physical activity has only considered middle-aged populations.

The study including 1,861 individuals born between 1920 and 1921 was the work of Jochanan Stessman, M.D., and colleagues at Hebrew University Medical Center and Hebrew University Hadassah Medical School, Jerusalem. Participants underwent evaluations in their homes at ages 70, 78 and 85 years, during which they were asked about their physical activity levels. Those who performed less than four hours per week of physical activity were considered sedentary. Those who exercised about four hours weekly, performed vigorous activities such as jogging or swimming at least twice weekly or who engaged in regular physical activity, such as walking at least an hour daily, were considered physically active.

The proportion of participants who were physically active was:
• 53.4 percent at age 70
• 76.9 percent at age 77
• 64 percent at age 85

When compared with those who were sedentary, individuals who were physically active were:
• 12 percent less likely to die between ages 70 and 78
• 15 percent less likely to die between ages 78 and 85
• 17 percent less likely to die between ages 85 and 88

They were more likely to remain independent and experienced fewer declines in their ability to perform daily tasks. In addition, they reported a smaller number of new instances of loneliness:
• 12.2 percent vs. 22.6 percent from ages 70 to 78
• 26.5 percent vs. 44.1 percent from ages 78 to 85

There were also variations in poor self-rated health:
• 77.3 percent vs. 63.3 percent from ages 70 to 78
• 63.8 percent vs. 82.6 percent from ages 78 to 85

The benefits related with physical activity were observed not only in those who maintained an existing level of physical activity, but also in those who began exercising between ages 70 and 85.

The authors write: “Although the mechanism of the survival benefit is most likely multifactorial, one important finding was the sustained protective effect of physical activity against functional decline.” Physical activity may postpone the spiral of decline that begins with inability to perform daily activities and continues through illness and death. Exercise improves cardiovascular fitness, slows loss of muscle mass, reduces fat, improves immunity and suppresses inflammation.

“Despite the increasing likelihood of comorbidity, frailty, dependence and ever-shortening life expectancy, remaining and even starting to be physically active increases the likelihood of living longer and staying functionally independent,” the authors explain. “The clinical ramifications are far reaching. As this rapidly growing sector of the population assumes a prominent position in preventive and public health measures, our findings clearly support the continued encouragement of physical activity, even among the oldest old. Indeed, it seems that it is never too late to start.”

Arch Intern Med. 2009; 169[16]:1476-1483.

JAMA

Stephanie Brunner (B.A.)