The Older You Are and the More Physically Active You Are, the Longer You Will Live Disease-Free

I have written about the benefits of physical activity, ad nauseam, for over a year. Whichever way you look at the data, any form of physical activity is better than none and the more active you are, the less is the risk of cardiovascular disease and lower is the associated and all-cause mortality. Except for elite athletes, who make up less than 1% of the world’s population, the rest of the adult world is broadly equally divided into sedentary (non-active) and physically active (PA) individuals.

While we know that PA in any form is useful, is there an ideal age to start? Is later in life too late? When do we stop? Should we stop? Or do we continue to be physically active all our lives? Does PA still help when we are in our 80s and 90s?

There are recent studies that help us answer these questions to some extent.

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The first is is a longitudinal study by Claudio Barbiellini Amidei and colleagues [1] that looked at 3099 Italians 65 years and older and followed them up for 21 years from 1997 to 2018. They divided the participants into four categories based on whether they were physically active (> 20 minutes of PA per day) or not (< 20 minutes per day); stable low (inactive-inactive), stable high (active-active), high-decreasing (active-inactive) and low-increasing (inactive-active).  Those with an increasing incidence of PA had lower rates of cardiovascular and coronary artery disease, i.e. high-decreasing was less effective than low-increasing, while stable high was the best and all three were better than stable low. While the results reinforce the fact that any PA is better than none, they also tell us that PA levels should be maintained throughout life and/or should increase, but not reduce.

The best results were for those aged 70-75, after which the benefits seemed to taper off, suggesting that between 65-70 years is the best time to start or increase PA, if you have been sedentary till then. If you are already active, then all you have to do is continue being active or increase your activity levels as best as you can.

Another study headed by Daniel Aggio [2] from the British Regional Heart Study looked at 3 PA group trajectories; low-decreasing, light/stable and moderate-increasing. They found that both, light/stable and moderate-increasing trajectories conferred mortality benefits. However, the best benefits came from recent/current PA, which means that if you were active once and have then stopped, any benefit you had accrued would be much lower than those who continued to be active or increased their activity levels.

Practically it is rare for activity to increase as we grow older - our PA levels either remain stable or decrease for a variety of practical reasons, ranging from reduced energy to frailty to illnesses to lack of independence, etc.

So to summarize,

1. Any physical activity is better than none.
2. There is no age barrier for physical activity.
3. The earlier you start, the better.
4. It is important to continue to be physically active forever.
5. If you stop being physically active for any reason, you start losing its benefits over time.

The same holds true for PA and cognitive decline as we grow older. A group headed by Boris Cheval [3] looked at 38,729 individuals from the SHARE study. They identified two groups, constantly high and decreasing PA. In those over the age of 50, decreasing PA was associated with a lower level and steeper decline of cognitive performance, again telling us that it is important not only to be physically active, but to maintain the same levels of activity as we grow older.

In fact, a group headed by Joanna Gronek [4] suggests that those over 65 years of age should actually increase their PA levels to beyond those mentioned in the guidelines (i.e. more than 150-300 minutes of moderate PA per week) to improve longevity, reduce cardiovascular risk and reduce cognitive decline.

Physical activity is the one magic pill that makes all the difference to the quality of our later lives. The more active you are, the more healthy you will be. In our healthful ageing quest, the Atmasvasth way, it is imperative to be physically active, at any age, for any duration, till the day we die.

The Nine Previous Articles on Physical Activity

Physical Activity - Atmasvasth

Atmasvasth

Footnotes

1. Barbiellini Amidei C et al. Association of physical activity trajectories with major cardiovascular diseases in elderly people. Heart. 2022 Mar;108(5):360-366.

2. Aggio D, Papachristou E et al. Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality. J Epidemiol Community Health. 2020 Feb;74(2):130-136.

3. Cheval B et al. Association between physical-activity trajectories and cognitive decline in adults 50 years of age or older. Epidemiol Psychiatr Sci. 2021 Dec 27;30:e79.

4. Gronek J e al. Exercise in Aging: Be Balanced. Aging Dis. 2021 Aug 1;12(5):1140-1149.