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Physical Inactivity and Short-term All-Cause Mortality in Adults With Chronic Disease
Brian C. Martinson, PhD;
Patrick J. O'Connor, MD, MPH;
Nicolaas P. Pronk, PhD
Arch Intern Med. 2001;161:1173-1180.
Objective To ascertain the relationship of physical inactivity and short-term
all-cause mortality in a prospective cohort of randomly selected managed care
organization members aged 40 years and older who have multiple chronic diseases.
Methods Clinical databases were used to identify all health plan members aged
40 years and older with 2 or more chronic health conditions (hypertension,
coronary heart disease, diabetes mellitus, or dyslipemia) in 1994. A random
sample of 2336 members was surveyed by mail and telephone interview regarding
their health-related behaviors. Survey data were linked to mortality data
from the 1995 to 1997 Minnesota Death Index. Cox proportional hazards regression
was used to ascertain the association between physical inactivity and subsequent
all-cause mortality, adjusting for potential confounders.
Results Members who reported less than 30 minutes a week of physical activity
at baseline had a subsequent mortality risk ratio of 2.82 (P<.001) vs those with 30 or more minutes of physical activity a
week. Increased mortality risk persisted (mortality risk ratio, 2.15; P<.001) after adjustments for age, sex, current smoking,
functional impairment, and comorbidity score.
Conclusions In adults with chronic diseases, the physically inactive had higher
observed mortality within a 42-month period. If physical inactivity reflects
an independent mortality risk, efforts to maintain physical activity in such
patients may yield significant clinical benefits within a short period. By
contrast, if inactivity is primarily a proxy for other factors that elevate
mortality risks, a simple physician inquiry regarding inactivity may help
to identify patients at risk of death.
From HealthPartners Research Foundation (Drs Martinson and O'Connor)
and HealthPartners Center for Health Promotion (Dr Pronk), Minneapolis, Minn.
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