Elsevier

Preventive Medicine

Volume 45, Issues 2–3, August–September 2007, Pages 169-176
Preventive Medicine

Changes in leisure time physical activity and risk of all-cause mortality in men and women: The Baltimore Longitudinal Study of Aging

https://doi.org/10.1016/j.ypmed.2007.05.014Get rights and content

Abstract

Background

Higher levels of leisure time physical activity (LTPA) are associated with reduced mortality. However it is unclear how changes in LTPA over time impact all-cause mortality in men and women.

Methods

From 1958 to 1996 for men (n = 1316) and 1978 to 1996 for women (n = 776), participants aged 19–90+ years from the Baltimore Longitudinal Study of Aging (Baltimore, MD) were assessed for LTPA at baseline and at ∼ 2-year intervals over a mean follow-up of 21.2 ± 9.4 years for men and 10.2 ± 5.6 years for women. Death occurred in 538 men and 90 women. LTPA was derived from self-reports of time spent in 97 activities converted into MET-min per 24 h and was further grouped into high-, moderate- and low-intensity LTPA. The longitudinal data was analyzed using mixed effects models to determine the rate of change in LTPA at each assessment. Proportional hazard models were used to assess the associations between LTPA at baseline and rate of change in LTPA with all-cause mortality.

Results

In younger (< 70 years) men, those who reported increases or negligible declines in total and high-intensity LTPA had lower all-cause mortality compared to those with greater declines in LTPA. In older (≥ 70 years) men, the association between rate of change in high-intensity LTPA and mortality was similar to that seen in younger men. For women, longitudinal analyses showed neither rates of change in total, high-, moderate- nor low-intensity LTPA were predictive of mortality.

Conclusions

In this health-conscious population, greater longitudinal declines in total and high-intensity LTPA are independent predictors of all-cause mortality in men.

Introduction

The protective role of physical activity against cardiovascular events and mortality has become increasingly evident over the past several decades (Lee et al., 1995, Paffenbarger et al., 1978, Paffenbarger et al., 1986, Lindsted et al., 1991, Morris et al., 1990). Higher levels of physical activity are associated with a reduced rate of all-cause mortality (Leon et al., 1987, Paffenbarger et al., 1993, Slattery and Jacobs, 1988). Plausibly, changes in patterns of physical activity over time may influence mortality, independent of cross-sectional activity levels.

With increased age, there is a decline in overall leisure time physical activity (LTPA). In a cross-sectional analysis of LTPA in the Baltimore Longitudinal Study of Aging (BLSA), we observed a reduction in total LTPA in both sexes with advancing age that was mediated by a striking reduction in high-intensity (≥ 6 METS) activities (Talbot et al., 2000). The declines in physical activity are not unique to humans and are observed in other species (Ingram, 2000). These observations in both human and animals suggest that changes in physical activity over time may independently influence longevity; however, the independent contribution of change in physical activity to all-cause mortality remains unresolved. Because most BLSA participants would be expected to have changed their activity patterns over time, it might be possible to observe the influence of such changes in physical activity on longevity. The purpose of this study therefore was to examine the effect of change in self-reported LTPA on all-cause mortality in apparently healthy adult men and women across a broad age spectrum.

Section snippets

Study population

The participants are men and women aged 19–90+ years from the BLSA, a prospective study of aging. Participants in the BLSA are community-residing volunteers who generally have above average income, high education levels, and good access to medical care; over 90% of BLSA participants rate their health as good or excellent. From 1958 to 1996 for men and 1978 to 1996 for women, participants visited the Gerontology Research Center in Baltimore, MD at ∼ 2-year intervals for 2 days of research

Baseline characteristics

Descriptive statistics for younger (< 70 years old) and older (≥ 70 years) men and women are presented in Table 1, Table 2. Among younger men, those who died were older, had shorter follow-up, higher cholesterol, more hypertension, and performed less of each type of LTPA at baseline than survivors. More of the men who died were former smokers or had smoked during their tenure in the BLSA. Baseline body mass index (BMI) did not differ between those who died and those who survived. The levels of

Discussion

In this well-educated and health-conscious population, both being physically active at baseline with higher levels of total and high-intensity LTPA and maintaining a more positive (i.e. less negative) longitudinal change in total and high-intensity LTPA were associated with lower mortality rates in younger (< 70 years) and older (≥ 70 years) men. For both younger (< 70 years) and older (≥ 70 years) women, being physically active at baseline through higher levels of total, moderate- and low-, but

Acknowledgments

The authors would like to express their appreciation to the volunteers in the Baltimore Longitudinal Study of Aging and to Drs. Reubin Andres, Edward Lakatta, and James Nagel for coding the cause of death. This research project was supported by the Intramural Research Program of the National Institutes of Health, National Institute on Aging.

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    The views expressed are those of the author and do not reflect the official policy or position of Uniformed Services University of the Health Sciences, the Department of Defense, or the United States Government.

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