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The Zutphen Elderly Study

Fransje C. H. Bijnen, PhD; Carl J. Caspersen, PhD, MPH; Edith J. M. Feskens, PhD; Wim H. M. Saris, PhD, MD; Willem L. Mosterd, PhD, MD; Daan Kromhout, PhD, MPH

Arch Intern Med. 1998;158:1499-1505.

Background  Little is known about physical activity and mortality risk in the elderly. Therefore, we describe the associations between the physical activity pattern of elderly men and the mortality from cardiovascular diseases (CVDs), particularly coronary heart disease (CHD) and stroke, and all causes.

Methods  Self-reported physical activity was assessed with a validated questionnaire for retired men in a population-based sample of 802 Dutch men, aged 64 to 84 years at baseline. Relative risks were estimated for 10-year mortality from CVD (199 deaths), CHD (90), stroke (47), and all causes (373) for tertiles of time spent on physical activity (reference, lowest tertile). Adjustments were made for baseline age, relevant major chronic diseases, cigarette smoking, and alcohol consumption.

Results  Mortality risks from CVD and all causes decreased with increasing physical activity (P for trend=.04) with adjusted relative risks of 0.70 (95% confidence interval, 0.48-1.01) and 0.77 (95% confidence interval, 0.59-1.00) in the highest tertile of total physical activity, respectively. Except for CHD, time spent in more intense activities (4 kcal/kg per hour) was more strongly associated with all mortality outcomes than less intense activities, but no single type of activity was particularly protective. Walking or cycling at least 3 times per week for 20 minutes (our definition of activity based on general health recommendations) was associated with reduced mortality from CVD (adjusted relative risk, 0.69; 95% confidence interval, 0.50-0.88) and all causes (relative risk, 0.71; 95% confidence interval, 0.58-0.88). Additional adjustment for biological cardiovascular risk factors did not affect the strength of any association.

Conclusion  In a general population of elderly men, physical activity may protect against mortality from CVDs and all causes.

From the Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and the Environment, Bilthoven (Drs Bijnen, Feskens, and Kromhout), the Department of Medical Physiology and Sports Medicine, Utrecht University, Utrecht (Drs Bijnen and Mosterd), the Department of Human Biology, University of Limburg, Maastricht (Dr Saris), the Netherlands; and the Physical Activity and Health Branch, Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Caspersen).

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