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. 2008 Aug 11;168(15):1638-46.
doi: 10.1001/archinte.168.15.1638.

Reduced disability and mortality among aging runners: a 21-year longitudinal study

Eliza F Chakravarty  1 , Helen B Hubert, Vijaya B Lingala, James F Fries
Affiliations

Reduced disability and mortality among aging runners: a 21-year longitudinal study

Eliza F Chakravarty et al. Arch Intern Med. .

Erratum in

  • Arch Intern Med. 2008 Dec 8;168(22):2496

Abstract

Background: Exercise has been shown to improve many health outcomes and well-being of people of all ages. Long-term studies in older adults are needed to confirm disability and survival benefits of exercise.

Methods: Annual self-administered questionnaires were sent to 538 members of a nationwide running club and 423 healthy controls from northern California who were 50 years and older beginning in 1984. Data included running and exercise frequency, body mass index, and disability assessed by the Health Assessment Questionnaire Disability Index (HAQ-DI; scored from 0 [no difficulty] to 3 [unable to perform]) through 2005. A total of 284 runners and 156 controls completed the 21-year follow-up. Causes of death through 2003 were ascertained using the National Death Index. Multivariate regression techniques compared groups on disability and mortality.

Results: At baseline, runners were younger, leaner, and less likely to smoke compared with controls. The mean (SD) HAQ-DI score was higher for controls than for runners at all time points and increased with age in both groups, but to a lesser degree in runners (0.17 [0.34]) than in controls (0.36 [0.55]) (P < .001). Multivariate analyses showed that runners had a significantly lower risk of an HAQ-DI score of 0.5 (hazard ratio, 0.62; 95% confidence interval, 0.46-0.84). At 19 years, 15% of runners had died compared with 34% of controls. After adjustment for covariates, runners demonstrated a survival benefit (hazard ratio, 0.61; 95% confidence interval, 0.45-0.82). Disability and survival curves continued to diverge between groups after the 21-year follow-up as participants approached their ninth decade of life.

Conclusion: Vigorous exercise (running) at middle and older ages is associated with reduced disability in later life and a notable survival advantage.

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Conflict of interest statement

The authors have no competing conflicts of interest to declare.

Figures

Figure 1
Figure 1. Mean disability levels by year
(1A) Runners’ Club members versus Community Control subjects. Data from all initial participants (solid lines) and for those who continued participation through 2005 (dashed lines) (1B) Ever-Runners versus Never-Runners. Data from all initial participants (solid lines) and for those who continued participation through 2005 (Dashed Lines)
Figure 1
Figure 1. Mean disability levels by year
(1A) Runners’ Club members versus Community Control subjects. Data from all initial participants (solid lines) and for those who continued participation through 2005 (dashed lines) (1B) Ever-Runners versus Never-Runners. Data from all initial participants (solid lines) and for those who continued participation through 2005 (Dashed Lines)
Figure 2
Figure 2
Mean disability levels by year separated by gender. Mean and standard deviation for runners (solid lines) and controls (dashed lines) by year from 1984 through 2005. Male subjects are depicted with open triangles and females with solid triangles. Only subjects who completed the 21-years of follow-up are included.
Figure 3
Figure 3
Progression of Disability. Linear mixed models of progression of disability and postponement of disability (PD). Regression lines are derived from linear mixed models and adjusted for the following covariates: age, sex, BMI, smoking, and initial disability level. The PD is defined as the absolute difference between the 2 groups in the time required to cross a given level of disability. Example shown is to reach HAQ-DI of 0.15.
Figure 4
Figure 4
Kaplan-Meier unadjusted survival curves for all cause mortality in Runners Club members and Community Controls from study onset through 19 years of follow-up. All 941 subjects at study inception are included. The difference between groups remained significant (p<0.001 by log rank test).
See this image and copyright information in PMC

Comment in

  • Weighing benefits for older runners.
    Mackey RH. Mackey RH. Arch Intern Med. 2008 Oct 13;168(18):1948-9. doi: 10.1001/archinte.168.18.1948. Arch Intern Med. 2008. PMID: 18852394 Review. No abstract available.
  • On running late in life.
    Höglund P, Nilsson LA. Höglund P, et al. Arch Intern Med. 2009 Apr 13;169(7):719-20; author reply 720. doi: 10.1001/archinternmed.2009.35. Arch Intern Med. 2009. PMID: 19365008 No abstract available.
  • Incidence of atrial fibrillation among aging runners.
    Laurent M. Laurent M. Arch Intern Med. 2009 Apr 13;169(7):719. doi: 10.1001/archinternmed.2009.34. Arch Intern Med. 2009. PMID: 19365009 No abstract available.

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