Author Insights: Midlife Fitness May Ease the Burden of Chronic Disease Later in Life

Jarett D. Berry, MD, MS, of the University of Texas Southwestern Medical Center in Dallas, and colleagues found that having high levels of fitness in middle age is associated with avoiding or delaying chronic disease in late life. (Image: UT Southwestern Medical Center)

Being fit in middle life appears protective against developing chronic diseases later in old age and is also associated with living the final 5 years of life with fewer chronic diseases. The findings appear today in the Archives of Internal Medicine.

Researchers from the Cooper Institute and the University of Texas Southwestern Medical Center in Dallas studied 18 670 healthy participants in the Cooper Center Longitudinal Study who lived long enough to receive Medicare coverage (a benefit that typically becomes available at age 65 years) from 1999 through 2009. Fitness in midlife was assessed by a Balke treadmill test. The median age of the study population at the time of enrollment was 49 years, and 21% of them were women. Using Medicare data to determine which participants had certain chronic conditions, the researchers found that for both men and women, those who had been in the highest quintile of fitness in middle age were less likely than those who had been in the lowest quintile of fitness in middle age to have 1 or more chronic conditions. The chronic conditions assessed were congestive heart failure, ischemic heart disease, stroke, diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, Alzheimer disease, and colon or lung cancer.

Coauthor Jarett D. Berry, MD, MS, an assistant professor of internal medicine at the medical center, discusses his team’s findings:

“It’s been well established that individuals with higher levels of fitness live longer with fewer cardiovascular disease deaths, but we wanted to know about chronic disease levels earlier than just at the time of death. We wanted to know if people with higher levels of fitness not only live longer, but also live better. So we merged Medicare claims files with the Cooper Center data set with the goal of looking at levels of fitness and the overall burden of disease in older age.

“We showed that individuals with higher levels of fitness have a lower burden of chronic disease. We showed that with a higher level of fitness at age 50, not only are we delaying the onset of these chronic conditions, we’re preventing them. Also, we found a compression of morbidity: the burden of these chronic conditions is being compressed into a shorter period of time later in life for those with high levels of fitness at age 50.

“These findings have a broader implication for fitness in that it provides true health benefits—not just in delaying chronic disease, but preventing it. The things we do in our 50s can affect the remainder of our lives.”

Categories: Cardiovascular Disease/Myocardial Infarction, Diabetes Mellitus, Exercise, Quality of Life