Twenty minutes of moderate to vigorous daily exercise in early old age (70-75) may better prevent major heart disease, including heart failure, in late old age (80 and older), suggests a research published online in the journal Heart.
The results reinforce the ‘better late than never’ maxim when it comes to exercise, but earlier in old age is even better, a linked editorial concludes.
It’s no secret that physical activity is associated with a lower risk of cardiovascular disease and a longer life, regardless of gender and ethnicity, with the benefits accruing in tandem with effort expended.
But relatively few studies have looked exclusively at whether exercise later in life can help prevent heart disease and stroke in older adults.
To fill this knowledge gap, the researchers relied on data from Progetto Veneto Anziani (ProVA), a study of 3,099 elderly Italians (65 years and older).
Initial evaluations, including a detailed medical history, physical exam, CT scans and a battery of blood tests were performed between 1995 and 1997, with two further evaluations 4 and 7 years later.
At the start of the study, women were more likely than men to have 4+ coexisting conditions, with a higher prevalence of osteoarthritis, osteoporosis, and chronic kidney disease; chronic obstructive pulmonary disease (COPD) and diabetes were more common in men.
Participants completed questionnaires about their level of physical activity at each time point. Moderate physical activity included walking, bowling, and fishing, while vigorous physical activity included gardening, gym workouts, cycling, dancing, and swimming.
Those whose physical activity totaled 20 minutes or more per day were defined as active; those who recorded less than that were defined as inactive. Men were more likely to be physically active than women.
Changes in physical activity patterns were defined as: stable-low (inactive-inactive); up-down (on-off); low-rise (inactive-active); and stable-high (active-active).
Other potentially important background information on household income, level of education, number of household members, smoking and alcohol was also collected.
The health of all participants was then tracked through a link to hospital discharge records and death certificate through the end of December 2018. The final analysis included 2754 participants with complete data, including 1398 were women (60%).
During the monitoring period, 1037 new diagnoses of heart disease, heart failure and stroke were made.
Increasing levels of physical activity as well as maintaining an active lifestyle over time were associated with lower risks of cardiovascular disease and death in both men and women.
The greatest risk reduction was observed for new cases of coronary heart disease and heart failure in old age. No significant association between physical activity and stroke was observed.
Most participants had stable active physical activity patterns over time. Steady-high physical activity patterns were associated with a significantly (52%) lower risk of cardiovascular disease in men compared to those with steady-low patterns.
The greatest benefits seemed to occur at age 70. The risk was only slightly lower at age 75 and not lower at age 80 to 85, suggesting that improving physical activity earlier in old age may have the greatest impact. impact, say the researchers.
A J-shaped curve for exercise duration was also observed, with the greatest reduction in heart disease and heart failure associated with 20-40 minutes of moderate-to-vigorous physical activity. every day.
While the observed associations were strongest in men, the researchers point out: “Women doing more physical activity had consistently lower incidence rates for almost all cardiovascular outcomes despite the fact that the reduced risk n did not reach statistical significance, but when considering overall mortality, the risks were reduced significantly.”
This is an observational study, and as such cannot establish cause. The researchers acknowledge that the study relied on participant recall, physical activity levels were assessed subjectively, and no data were available on midlife physical activity levels. , all of which may have influenced end-of-life cardiovascular risk profiles.
Nevertheless, they conclude: “These findings suggest that public health policies should be targeted at promoting or initiating physical activity in middle and early late life, given likely greater efficacy in reducing cardiovascular risk.
“At least 20 minutes of moderate to vigorous physical activity per day should be recommended for the greatest cardiovascular benefits.”
In a linked editorial, Drs Enrico Fabris and Gianfranco Sinagra of the University of Trieste, Italy, explain that physical activity helps improve arterial blood flow and can reduce its adherence and therefore the formation of blood clots.
“However, the detailed mechanisms by which [physical activity] can reduce the future risk of [cardiovascular disease] are not fully understood,” they point out.
“The favorable effect of [physical activity] can be explained simply by its ability to slow down the process of atherosclerosis through better control of blood pressure, blood sugar and lipid profile.
But the results show: “that ‘movement is medicine’ also at the end of life. Even a small amount of [physical activity] may have beneficial effects in the elderly, but if undertaken sooner rather than later,” they conclude.
The title of the article
Association of physical activity trajectories with major cardiovascular diseases in older adults
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