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Apr 04, 2019

Fitness is a Strong Predictor of Survival in Adults Over 70

Traditional risk factors are so common in older people that they become almost meaningless for predicting future health.

By the age of 70, fitness is a better predictor of survival than traditional risk factors for heart disease, based on a study of more than 6,500 older adults. Findings were recently presented at the American College of Cardiology’s 68th Annual Scientific Session and highlight the importance of staying active in your golden years.

Conducted by researchers at the Johns Hopkins School of Medicine, this study looked at a number of factors associated with survival in adults aged 70 and older. The goal was to see how well traditional cardiovascular risk factors like high blood pressure and diabetes predict survival in older adults, especially in comparison to fitness.

According to Seamus P. Whelton, MD, MPH, assistant professor of medicine at Johns Hopkins School of Medicine and the study’s lead author, doctors tend to use cardiovascular risk factors to help guide decisions about prevention and treatment. Previous studies have shown that quitting smoking and controlling blood pressure, cholesterol and diabetes can reduce heart disease risk. However, most studies of cardiovascular risk factors have focused on middle-aged people, leaving a knowledge gap in older adults.

For the recent study, more than 6,500 adults underwent an exercise stress test at a Henry Ford Health Systems-affiliated medical center between 1991 and 2009. During the test, participants exercised on a treadmill as hard as they could to assess their fitness level. Participants were then divided into three groups ranging from least to most fit. Researchers also grouped participants based on how many cardiovascular risk factors they had.

Participants were 75 years old, on average, when they underwent the stress test and were followed for an average of ten years.

By the end of the study, 39% of participants had died. Researchers found that the most fit individuals were more than twice as likely to be alive ten years later than the least fit individuals. However, a patient’s total number of cardiovascular risk factors was not associated with their risk of death. In fact, patients with zero risk factors had essentially the same likelihood of dying as those with three or more risk factors.

What findings show, according to authors, is the importance of staying active as we get older.

It’s true that factors like high blood pressure, high cholesterol, diabetes and smoking are closely linked with a person’s chance of developing heart disease. However, these factors are so common in older people that the total number of risk factors becomes almost meaningless for predicting future health, researchers said. The new study suggests doctors can get a better picture of older patients’ health by looking at how fit they are, rather than how many of these cardiovascular risk factors they have.

“We found fitness is an extremely strong risk predictor of survival in the older age group—that is, regardless of whether you are otherwise healthy or have cardiovascular risk factors, being more fit means you’re more likely to live longer than someone who is less fit,” said Whelton. “This finding emphasizes the importance of being fit, even when you’re older.”

Whelton also encourages better screening and education for fitness, especially among older adults. While an exercise stress test using a treadmill or stationary bicycle provides the most precise way to measure fitness, doctors can also get a general idea of a patient’s fitness level by asking about their exercise routine.

“Assessing fitness is a low-cost, low-risk and low-technology tool that is underutilized in clinical practice for risk stratification,” Whelton said. “People who aren’t exercising or are sedentary would likely benefit from starting a routine of low- to moderate-intensity exercise, though they should talk with their physician first.”

Questions for You to Consider

  • How can I reduce my risk for heart disease?
  • Healthy lifestyle choices are key to reducing risk for heart disease. By eating a heart-healthy diet and staying physically active, you can help significantly reduce heart disease risk. Knowing your numbers—body mass index, blood pressure, cholesterol, and blood sugar—and family history is also important so that you can address any risk factors you may have for heart disease.
  • How much exercise do I need?
  • Regular physical activity is important for both children and adults. According to the 2008 Physical Activity Guidelines for Americans:

    • Children and adolescents should get 60 minutes or more of physical activity daily.
    • Optimum exercise levels for adults includes:
      • 150 minutes of moderate-intensity or 75 minutes of vigorous exercise (or a combination of the two) each week.
      • Activity spread across the week with periods of aerobic exercise of at least 10 minutes at a time.
      • Muscle strengthening activities 2 or more days a week.

Infographic: Health Tips for Older Adults


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