Physical Activity at Midlife in Relation to Successful Survival in Women at 70 Years or Older

A reduced risk of several chronic diseases is associated with physical activity. However, there is no clear evidence that increased physical activity among individuals who survive to older ages improves overall health or that the incidence of premature death is decreased. Most studies investigating the role of physical activity on overall health and survival at older ages have involved men; there are few data for aging women. This study assessed the relationship between physical activity at midlife in women 70 years or older and improvements in overall health and successful survival. The latter was defined as no history of 10 major chronic diseases or coronary artery bypass graft surgery and no cognitive or physical impairment or mental health limitations. The study population was comprised of 13,535 women enrolled in the Nurses' Health Study who were free of major chronic diseases at the study baseline in 1986 and had survived to age 70 years or older as of 1995 to 2001. Energy expenditure in metabolic-equivalent tasks (METs) were calculated for each type of physical activity examined. Multivariate logistic regression models were used to adjust for variables. Higher physical activity levels at midlife were significantly associated with a greater likelihood of successful survival; the adjusted odds ratios for successful survival across quintiles (shown with 95% confidence levels [CI]) were 1 (reference), 0.98 (0.80–1.20), 1.37 (1.13–1.65), 1.34 (1.11–1.61), and 1.99 (1.66–2.38) for total METs (P < 0.001 for trend). A similar improved likelihood of successful survival was found for increasing energy expenditure from walking; the adjusted odds ratios for successful survival across walking METs quintiles were 1 (reference), 0.99 (0.80–1.21), 1.19 (0.97–1.45), 1.50 (1.24–1.82), and 1.47 (1.22–1.79) (P < 0.001 for trend). These findings demonstrate that midlife physical activity among women who are initially healthy at midlife and survive to older ages are strongly associated with successful survival or exceptional overall health in later life.