This article is more than 5 years old. Information may no longer be current.
Midlife fitness helps prevent later depression, CVD mortality
Click Here to Manage Email Alerts
Being fit at midlife was associated with lower risk for depression diagnosis after age 65 years, and for cardiovascular disease mortality, even after depression diagnosis in later life, findings published in JAMA Psychiatry revealed.
“There is a well-known connection between depression and cardiovascular disease,” Benjamin L. Willis, MD, MPH, of The Cooper Institute in Dallas, told Healio Psychiatry. “People with CVD are at greater risk for depression and people who are depressed are at greater risk of experiencing a CVD incident, like a heart attack, in later life.”
Researchers conducted a retrospective cohort study of generally healthy men and women enrolled in the Cooper Center Longitudinal Study to determine the association between fitness measured at midlife and later-life depression and CVD mortality with antecedent depression.
The study included 17,989 participants without history of depression, myocardial infarction or stroke who presented for preventive medicine examinations at midlife and were eligible for Medicare from 1999 to 2010. The investigators measured objective midlife fitness from results of treadmill exercise testing and depression diagnosis from Medicare claims files and CVD mortality from National Death Index records.
Among the participants (80.2% men; mean age 50 years), there were 2,701 depression diagnoses, 610 deaths due to CVD without prior depression and 231 deaths due to CVD after depression observed after 117,218 person-years of Medicare follow-up.
The results showed that participants with high level of fitness at midlife were 16% less likely to have depression than those with low level of fitness (HR = 0.84; 95% CI, 0.74-0.95). Adults with high fitness levels were also at 61% lower risk for CVD-related death without depression than adults with low fitness levels at middle age (HR = 0.39; 95% CI, 0.31-0.48). After depression diagnosis, patients with high levels of fitness were 56% less likely to die due to CVD than those with low levels of fitness (HR = 0.44; 95% CI, 0.31-0.64).
“Only 50% of Americans meet the minimum guidelines for aerobic activity — the minimum standard published by HHS is 150 minutes per week),” Willis told Healio Psychiatry. “Fitness can reduce the risks of both depression and cardiovascular disease even over long periods of time.”
The rate of depression among middle-aged participants was 22.2 per 1,000 person-years among those with high fitness levels, 26.2 per 1,000 person-years among those with moderate fitness levels and 30.7 per 1,000 person-years among those with low fitness levels. The rate of CVD mortality without incident depression was 3.9 deaths per 1,000 person-years in the high-fitness group, 5.7 deaths per 1,000 person-years in the moderate-fitness group and 10.4 deaths per 1,000 person years in the low-fitness group. The CVD mortality rate after a depression diagnosis was 16.1 deaths per 1,000 person-years in the high-fitness group, 25.8 deaths per 1,000 person-years in the moderate-fitness group and 32.9 deaths per 1,000 person years in the low-fitness group.
“These findings suggest the importance of fitness in primary prevention of heart disease and associated CVD mortality in older aging adults,” Willis and colleagues wrote. “This study further supports the critical need for health care professionals to consider fitness and physical activity as part of overall preventive care to promote healthy aging.” – by Savannah Demko
Disclosure: The authors report no relevant financial disclosures.