Lower-intensity physical activity can produce CV benefits in older adults
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Two studies presented at the American Heart Association Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions highlighted the benefits of lighter physical activity in older adults.
According to these presentations, although more frequent and more vigorous physical activity is suggested by current guidelines, lighter-intensity activity may still have protective value for CV and all-cause mortality.
Moderate activity in older women
Among older women, higher volume exercise, even at moderate intensities, demonstrated protective effects against CV death, according to research presented at the American Heart Association Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions.
Researchers hypothesized that the standard 10,000 steps per day for heart health, as measured by an acceleration tracker, is neither empirically based nor created with older adults in mind, according to a press release.
Women (mean age, 79 years) who walked 2,100 to 4,500 steps per day reduced their risk for CV death from MI, HF, stroke or other CVD by up to 38% compared with participants who walked less than 2,100 steps per day, researchers reported.
Moreover, women with more than 4,500 steps per day as measured by wearable accelerometer reduced the risk for CV death by up to 48%, according to the presentation.
“Despite popular beliefs, there is little evidence that people need to aim for 10,000 steps daily to get cardiovascular benefits from walking,” Andrea Z. LaCroix, PhD, distinguished professor and chief of epidemiology at the University of California, San Diego, said in the release. “Our study showed that getting just over 4,500 steps per day is strongly associated with reduced risk of dying from cardiovascular disease in older women.”
In other findings, compared with women who took less than 2,100 steps per day, those who took between 2,100 and 4,500 steps per day had reduced risk for CV death after adjustment for BMI (HR = 0.21; 95% CI, 0.09-0.49; P for trend < .001), CVD risk biomarkers (HR = 0.22; 95% CI, 0.09-0.53; P for trend < .001) and step cadence (HR = 0.34; 0.14-0.8; P for trend = .004).
Between 2012 and 2014, researchers measured the steps of 6,000 older women using accelerometers worn on their waist for 7 days and followed them until March 2017.
“Taking more steps per day, even just a few more, is achievable, and step counts are an easy-to-understand way to measure how much we are moving,” LaCroix said in the release. “There are many inexpensive wearable devices to choose from. Our research shows that older women reduce their risk of heart disease by moving more in their daily life, including light activity and taking more steps. Being up and about, instead of sitting, is good for your heart.”
Physical activity and mortality
More physical activity for older adults, regardless of the intensity, and less sedentary time were associated with lower risk for all-cause mortality, even in participants with frailty.
In this study, lower risk for all-cause mortality was observed across varying metrics of physical activity (HR per 30 minute per day increment of total physical activity = 0.72; 95% CI, 0.59-0.88; HR per 30 minute per day increment of light-intensity physical activity = 0.73; 95% CI, 0.61-0.88; HR per 10 minute per day increment of moderate-to-vigorous physical activity = 0.89; 95% CI, 0.74-1.06; HR for meeting physical activity guidelines vs. not = 0.33; 95% CI, 0.15-0.74; HR per 30 minute per day increment of sedentary time = 1.32; 95% CI, 1.13-1.54).
The results remained consistent when patients with frailty were excluded, according to the researchers.
“Older adults often have difficulties performing moderate-to-vigorous physical activity,” Joowon Lee, PhD, postdoctoral research fellow with the T32 multidisciplinary training program in cardiovascular epidemiology at Boston University School of Medicine, told Healio. “However, our study indicates that even light-intensity physical activity may have beneficial effects on the risk of all-cause mortality. Because of this, encouraging even a small amount of light-intensity physical activity may be beneficial to prolonging life. Other studies indicate that moderate-to-vigorous physical activity is important in middle-aged or older adults to lower the risk of death. I would like to point out that light-intensity physical activity is very important, but if you are capable of performing moderate-to-vigorous physical activity, we strongly suggest meeting the current physical activity guidelines, which is achieving greater than 150 minutes per week of moderate-to-vigorous physical activity.”
Researchers assessed physical activity data of 1,262 participants from the Framingham Offspring study (mean age, 69 years; 54% women) who wore an accelerometer at least 10 hours per day for at least 4 days.
“All study participants are white individuals of European ancestry and we observed a small number of mortality cases in our investigation,” Lee told Healio. “Additional studies of larger multiethnic samples of older adults are warranted to confirm our findings.” – by Scott Buzby
References:
LaCroix AZ, et al. Presentation 30.
Lee J, et al. Presentation 31. Both presented at: American Heart Association Epidemiology, Prevention, Lifestyle and Cardiometabolic Health Scientific Sessions; March 3-6, 2020; Phoenix.
Disclosures: The authors report no relevant financial disclosures.