This population-based study examined how change in level of physical activity after middle age influences mortality, compared with smoking cessation. It is already established that physical activity can improve overall life expectancy but the effects of increases in activity later in life are not yet know.

 

The participants were 2205 men from Uppsala in Sweden who were aged 50 at the start of the study in 1970-3 and who were followed up for 35 years at ages 60, 70, 77, and 82 years. The main outcome measure was total (all cause) mortality and the effects of increasing physical activity were compared to those achieved through smoking cessation. The men were asked about their leisure-time physical activity through questions about their sedentary behaviour, walking and cycling, recreational sport and heavy gardening at each follow-up point. From these responses, they were categorised as low, medium or highly active.

 

Almost half of the men reported a high level of physical activity, 36% reported medium activity, corresponding to walks and cycling and 15% were sedentary. At the end of follow-up, data was available for 61,456 person years and 1,329 men (60%) had died. Following statistical analyses, the absolute mortality rate was 27.1, 23.6, and 18.4 per 1000 person years in the low, medium, and high physical activity groups, respectively. The relative rate reduction, compared to high physical activity, was 32% for low and 22% for the medium physical activity groups. Importantly, men who increased their physical activity level between ages 50 and 60 continued to have a higher mortality rate during the first five years of follow-up but after 10 years, increased physical activity was associated with reduced mortality to the level of men with unchanged high physical activity. This reduced mortality rate from increasing physical activity was similar to that found in smoking cessation.

 

These findings, from a well-designed, high quality study, highlight the fact that it is never too late to start being physically active as those who increase activity levels in middle age and older have a similar reduced rate of mortality to those who were active as younger adults and maintained their activity, at least in men. This message should be communicated to populations as a motivator for initiating and maintaining physical activity.