Even a Little Exercise May Reduce Mortality in Elders

Laird Harrison

August 04, 2015

Official guidelines should set lower exercise targets for people older than 60 years than for younger adults, a meta-analysis shows. This population can reduce its risk for death by about 22% with only half the recommended 150 minutes per week of moderate-intensity exercise, according to the new report.

"Based on these results, we believe that the target for physical activity in the current recommendations might be too high for older adults and may discourage some of them," write David Hupin, MD, from the Centre Hospitalier Universitaire de Saint-Étienne, Hôpital Nord, Service de Physiologie Clinique et de l'Exercice, Saint-Étienne, France, and colleagues.

They published their findings online August 3 in the British Journal of Sports Medicine.

The physical activity guidelines of the US Department of Health and Human Services do not distinguish between older and middle-aged adults, except to say that older adults limited by "chronic conditions" should "be as physically active as their abilities and conditions allow," the researchers note.

More than 60% of older adults find 150 minutes per week of moderate to vigorous exercise too demanding, the researchers write. Examples of moderate to vigorous activities include brisk walking, cycling, swimming, and gymnastics.

The researchers wanted to know whether people older than60 years could benefit from aiming at a lower target, so they searched the published literature to find out what levels of activity produced the most benefits in this population. Of a total of 835 relevant studies, they found nine suitable for analysis. These studies involved a total of 122,417 participants who were monitored for an average of around 10 years. During this period, 18,122 patients died.

The researchers translated findings in the different studies to metabolic equivalent of task (MET) minutes, which express the amount of calories expended per minute of physical activity. One MET minute is equal to the energy equivalent of just sitting.

Moderate-intensity activity ranges between 3 and 5.9 MET minutes, whereas vigorous-intensity activity is classified as 6 MET minutes or more. The current US Health and Human Services recommendation is for 500 to 1000 or more MET minutes every week.

After pooling the data from the studies, the researchers found that the more active people were, the lower their risk for death.

Relative to totally inactive people, participants getting 1 to 499 MET minutes of exercise per week cut their risk for death by 22%, those getting 500 to 999 MET minutes cut their risk by 28%, and those getting 1000 MET minutes or more cut their risk by 35%.

Reduced rates of heart disease and stroke accounted for most of the improvements in lifespan, although deaths from cancer were lower as well.

The greatest benefit seemed to accrue to those who went from doing nothing, or only a minimal amount of physical activity, to doing more.

Older women appeared to benefit more than older men from exercise, but the researchers speculate that this finding could stem from men overestimating their physical activity and women underestimating it.

From these findings, the researchers conclude that 250 MET minutes, which corresponds to 75 minutes per week of moderate to vigorous physical activity, was a more reasonable goal for adults older than 60 years. That is only 15 minutes per day 5 days a week, they note.

"The widespread diffusion of this message will encourage more older adults to include even low doses of [moderate- to vigorous-intensity physical activity] in their usual daily activities, without experiencing high levels of fatigue or of pain," the researchers conclude. "This message should be relayed by general practitioners who play a key and essential role in promoting physical acidity behaviour in older adults."

The authors have disclosed no relevant financial relationships.

Br J Sports Med. Published online August 3, 2015. Full text

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