National physical activity recommendations for older Australians: Discussion Document

4.1 Physical activity and reduced mortality and morbidity risk

The National Ageing Research Institute was commissioned by The Department of Health and Ageing to review the evidence and develop physical activity recommendations for older people.

Page last updated: 01 February 2011

Physical activity has therapeutic benefits from primary through to tertiary prevention. There is epidemiological evidence from prospective studies that regular physical activity is associated with a reduction in mortality risk. Data from trials and cross sectional studies confirm the range of health benefits that can accrue from physical activity. There are several reviews of this evidence (Bauman 2004; Taylor, Cable et al. 2004). A number of cohort studies have demonstrated that physical activity behaviour decreases the risk of all cause mortality, cardiovascular and respiratory mortality for both older men and women (Kushi, Fee et al. 1997; Bijnen, Caspersen et al. 1998). In postmenopausal women who exercised only once a week, the mortality risk was reduced (RR 0.78, 95% CI 0.64-0.96). Mortality risk from CVD and all causes decreased with increasing activity: for older men who were most physically active, the relative risks were 0.70 (95% CI 0.48-1.01) and 0.77 (95% CI 0.59-1.00) respectively. Amongst older South Australians, the mortality risk was 74% greater in sedentary older people compared to those who were active to some degree (Finucane, Giles et al. 1997). In the Dubbo study (Simons, Simons et al. 2006), daily walking predicted a 38% lower risk of dementia in men.

Several studies have also demonstrated the reduced risk associated with maintenance or adoption of physical activity, compared to remaining or becoming sedentary in older age. The Zutphen Elderly Study examined trends over five years in elderly Dutch men (Bijnen, Feskens et al. 1999). Their mean age at baseline was 75 years (SD 4.6 years). Adjustments were made for potential confounders such as health status. Although mean total time spent in physical activity declined over the study period, the mortality risk gradient increased from those becoming active (RR 1.36), to those becoming sedentary (RR 1.72) through to those remaining sedentary (RR 2.01).

Table 4.1 Relative risk for overall mortality in older people

Groups
RR (95% CI)
Zutphen Elderly Study
most active vs. least active
0.44 (0.25, 0.80)
Iowa Women Study
frequently active vs. inactive
0.77 (0.66, 0.90)
Source: Kushi, Fee et al. 1997; Bijnen, Caspersen et al. 1998

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