The World Health Organization (WHO) recommends at least 20 min/day of moderate to vigorous physical activity for older adults. A recent study added further value by suggesting that greater cardiovascular benefits might be achieved by improving physical activity earlier in late life. The study findings were published in the journal Heart on February 16, 2022.
Most studies have estimated health benefits based on a single measurement of physical activity, while a very relevant role seems to be played by trajectories of physical activity. Only few studies have examined the association of physical activity trajectories with specific cardiovascular outcomes, especially with regard to sex as well as age difference in elderly people. Therefore, Dr Claudio Barbiellini Amidei and his team conducted a study to examine how different trajectories of physical activity are associated with the incidence of cardiovascular events in older men and women.

In this study, the researchers used data from Progetto Veneto Anziani (Pro.V.A.) is a cohort study. It includes 3099 Italians aged ≥65 years with baseline assessment in 1995–1997 and follow-up visits at 4 and 7 years. Using hospital medical records and mortality data, the researchers were able to collect surveillance data through 2018. They identified prevalence and incident cardiovascular diseases (coronary heart disease, heart failure and stroke) through clinical examination, questionnaire, or hospital records. They determined moderate to vigorous physical activity as a time-varying variable. They categorized physical activity trajectories as: stable-low, high-decreasing, low-increasing and stable-high. Exposure was also assessed at 70, 75, 80 and 85 years.
Key findings of the study were:
Upon analysis, the researchers found that the physical activity was associated with lower rates of incident cardiovascular diseases.
They observed significant risk reduction was present among men and was stronger earlier in late life (70–75 years).
They noted that the trajectories of stable-high physical activity were associated with a significantly lower risk of cardiovascular outcomes among men (HR 0.48) compared with those with stable-low trajectories.
However, they observed no significant association with stroke.
The greatest cardiovascular risk reduction was observed for >20 min/day of physical activity, and was more marked at 70 years.
The authors concluded, "Physical activity and increasingly active trajectories of physical activity were also associated with a significantly lower mortality risk in both men and women. These results suggest that public health policies should be targeted at promoting or beginning physical activity in mid- and early late life, given a probable greater effectiveness in reducing cardiovascular risks. At least 20 minutes of moderate to vigorous physical activity per day should be recommended to achieve the greatest cardiovascular benefits."
For further information:
DOI: http://dx.doi.org/10.1136/heartjnl-2021-320013