Exercise capacity and mortality in older men: A 20-year follow-up study

Peter Kokkinos; Jonathan Myers; Charles Faselis; Demosthenes B. Panagiotakos; Michael Doumas; Andreas Pittaras; Athanasios Manolis; John Peter Kokkinos; Pamela Karasik; Michael Greenberg; Vasilios Papademetriou; Ross Fletcher

doi:https://doi.org/10.1161/CIRCULATIONAHA.110.938852

Exercise capacity and mortality in older men: A 20-year follow-up study

Peter Kokkinos, Jonathan Myers, Charles Faselis, Demosthenes B. Panagiotakos, Michael Doumas, Andreas Pittaras, Athanasios Manolis, John Peter Kokkinos, Pamela Karasik, Michael Greenberg, Vasilios Papademetriou, Ross Fletcher

Research output: Contribution to journal › Article › peer-review

208 Scopus citations

Abstract

Background-Epidemiological findings, based largely on middle-aged populations, support an inverse and independent association between exercise capacity and mortality risk. The information available in older individuals is limited. Methods and Results-Between 1986 and 2008, we assessed the association between exercise capacity and all-cause mortality in 5314 male veterans aged 65 to 92 years (mean±SD, 71.4±5.0 years) who completed an exercise test at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, Calif. We established fitness categories based on peak metabolic equivalents (METs) achieved. During a median 8.1 years of follow-up (range, 0.1 to 25.3), there were 2137 deaths. Baseline exercise capacity was 6.3±2.4 METs among survivors and 5.3±2.0 METs in those who died (P<0.001) and emerged as a strong predictor of mortality. For each 1-MET increase in exercise capacity, the adjusted hazard for death was 12% lower (hazard ratio=0.88; confidence interval, 0.86 to 0.90). Compared with the least fit individuals (≤4 METs), the mortality risk was 38% lower for those who achieved 5.1 to 6.0 METs (hazard ratio=0.62; confidence interval, 0.54 to 0.71) and progressively declined to 61% (hazard ratio=0.39; confidence interval, 0.32 to 0.49) for those who achieved >9METs, regardless of age. Unfit individuals who improved their fitness status with serial testing had a 35% lower mortality risk (hazard ratio=0.65; confidence interval, 0.46 to 0.93) compared with those who remained unfit. Conclusions-Exercise capacity is an independent predictor of all-cause mortality in older men. The relationship is inverse and graded, with most survival benefits achieved in those with an exercise capacity >5 METs. Survival improved significantly when unfit individuals became fit.

Original language	English (US)
Pages (from-to)	790-797
Number of pages	8
Journal	Circulation
Volume	122
Issue number	8
DOIs	https://doi.org/10.1161/CIRCULATIONAHA.110.938852
State	Published - Aug 24 2010
Externally published	Yes

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

Keywords

Aging
Epidemiology
Exercise
Mortality

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https://doi.org/10.1161/CIRCULATIONAHA.110.938852

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title = "Exercise capacity and mortality in older men: A 20-year follow-up study",

abstract = "Background-Epidemiological findings, based largely on middle-aged populations, support an inverse and independent association between exercise capacity and mortality risk. The information available in older individuals is limited. Methods and Results-Between 1986 and 2008, we assessed the association between exercise capacity and all-cause mortality in 5314 male veterans aged 65 to 92 years (mean±SD, 71.4±5.0 years) who completed an exercise test at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, Calif. We established fitness categories based on peak metabolic equivalents (METs) achieved. During a median 8.1 years of follow-up (range, 0.1 to 25.3), there were 2137 deaths. Baseline exercise capacity was 6.3±2.4 METs among survivors and 5.3±2.0 METs in those who died (P<0.001) and emerged as a strong predictor of mortality. For each 1-MET increase in exercise capacity, the adjusted hazard for death was 12% lower (hazard ratio=0.88; confidence interval, 0.86 to 0.90). Compared with the least fit individuals (≤4 METs), the mortality risk was 38% lower for those who achieved 5.1 to 6.0 METs (hazard ratio=0.62; confidence interval, 0.54 to 0.71) and progressively declined to 61% (hazard ratio=0.39; confidence interval, 0.32 to 0.49) for those who achieved >9METs, regardless of age. Unfit individuals who improved their fitness status with serial testing had a 35% lower mortality risk (hazard ratio=0.65; confidence interval, 0.46 to 0.93) compared with those who remained unfit. Conclusions-Exercise capacity is an independent predictor of all-cause mortality in older men. The relationship is inverse and graded, with most survival benefits achieved in those with an exercise capacity >5 METs. Survival improved significantly when unfit individuals became fit.",

keywords = "Aging, Epidemiology, Exercise, Mortality",

author = "Peter Kokkinos and Jonathan Myers and Charles Faselis and Panagiotakos, {Demosthenes B.} and Michael Doumas and Andreas Pittaras and Athanasios Manolis and Kokkinos, {John Peter} and Pamela Karasik and Michael Greenberg and Vasilios Papademetriou and Ross Fletcher",

year = "2010",

month = aug,

day = "24",

doi = "https://doi.org/10.1161/CIRCULATIONAHA.110.938852",

language = "English (US)",

volume = "122",

pages = "790--797",

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T1 - Exercise capacity and mortality in older men

T2 - A 20-year follow-up study

AU - Kokkinos, Peter

AU - Myers, Jonathan

AU - Faselis, Charles

AU - Panagiotakos, Demosthenes B.

AU - Doumas, Michael

AU - Pittaras, Andreas

AU - Manolis, Athanasios

AU - Kokkinos, John Peter

AU - Karasik, Pamela

AU - Greenberg, Michael

AU - Papademetriou, Vasilios

AU - Fletcher, Ross

PY - 2010/8/24

Y1 - 2010/8/24

N2 - Background-Epidemiological findings, based largely on middle-aged populations, support an inverse and independent association between exercise capacity and mortality risk. The information available in older individuals is limited. Methods and Results-Between 1986 and 2008, we assessed the association between exercise capacity and all-cause mortality in 5314 male veterans aged 65 to 92 years (mean±SD, 71.4±5.0 years) who completed an exercise test at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, Calif. We established fitness categories based on peak metabolic equivalents (METs) achieved. During a median 8.1 years of follow-up (range, 0.1 to 25.3), there were 2137 deaths. Baseline exercise capacity was 6.3±2.4 METs among survivors and 5.3±2.0 METs in those who died (P<0.001) and emerged as a strong predictor of mortality. For each 1-MET increase in exercise capacity, the adjusted hazard for death was 12% lower (hazard ratio=0.88; confidence interval, 0.86 to 0.90). Compared with the least fit individuals (≤4 METs), the mortality risk was 38% lower for those who achieved 5.1 to 6.0 METs (hazard ratio=0.62; confidence interval, 0.54 to 0.71) and progressively declined to 61% (hazard ratio=0.39; confidence interval, 0.32 to 0.49) for those who achieved >9METs, regardless of age. Unfit individuals who improved their fitness status with serial testing had a 35% lower mortality risk (hazard ratio=0.65; confidence interval, 0.46 to 0.93) compared with those who remained unfit. Conclusions-Exercise capacity is an independent predictor of all-cause mortality in older men. The relationship is inverse and graded, with most survival benefits achieved in those with an exercise capacity >5 METs. Survival improved significantly when unfit individuals became fit.

AB - Background-Epidemiological findings, based largely on middle-aged populations, support an inverse and independent association between exercise capacity and mortality risk. The information available in older individuals is limited. Methods and Results-Between 1986 and 2008, we assessed the association between exercise capacity and all-cause mortality in 5314 male veterans aged 65 to 92 years (mean±SD, 71.4±5.0 years) who completed an exercise test at the Veterans Affairs Medical Centers in Washington, DC, and Palo Alto, Calif. We established fitness categories based on peak metabolic equivalents (METs) achieved. During a median 8.1 years of follow-up (range, 0.1 to 25.3), there were 2137 deaths. Baseline exercise capacity was 6.3±2.4 METs among survivors and 5.3±2.0 METs in those who died (P<0.001) and emerged as a strong predictor of mortality. For each 1-MET increase in exercise capacity, the adjusted hazard for death was 12% lower (hazard ratio=0.88; confidence interval, 0.86 to 0.90). Compared with the least fit individuals (≤4 METs), the mortality risk was 38% lower for those who achieved 5.1 to 6.0 METs (hazard ratio=0.62; confidence interval, 0.54 to 0.71) and progressively declined to 61% (hazard ratio=0.39; confidence interval, 0.32 to 0.49) for those who achieved >9METs, regardless of age. Unfit individuals who improved their fitness status with serial testing had a 35% lower mortality risk (hazard ratio=0.65; confidence interval, 0.46 to 0.93) compared with those who remained unfit. Conclusions-Exercise capacity is an independent predictor of all-cause mortality in older men. The relationship is inverse and graded, with most survival benefits achieved in those with an exercise capacity >5 METs. Survival improved significantly when unfit individuals became fit.

KW - Aging

KW - Epidemiology

KW - Exercise

KW - Mortality

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ER -

Exercise capacity and mortality in older men: A 20-year follow-up study

Abstract

ASJC Scopus subject areas

Keywords

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