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Andrew S. Jackson, PED; Xuemei Sui, MD; James R. Hébert, ScD; Timothy S. Church, MD, PhD; Steven N. Blair, PED

Arch Intern Med. 2009;169(19):1781-1787.

Background  Cardiorespiratory fitness (CRF) in adults decreases with age and is influenced by lifestyle. Low CRF is associated with risk of diseases and the ability of older persons to function independently. We defined the longitudinal rate of CRF decline with aging and the association of aging and lifestyle with CRF.

Methods  We studied a cohort of 3429 women and 16 889 men, aged 20 to 96 years, from the Aerobics Center Longitudinal Study who completed 2 to 33 health examinations from 1974 to 2006. The lifestyle variables were body mass index, self-reported aerobic exercise, and smoking behavior. Cardiorespiratory fitness was measured by a maximal Balke treadmill exercise test.

Results  Linear mixed models regression analysis stratified by sex showed that the decline in CRF with age was not linear. After 45 years of age, CRF declined at an accelerated rate. For each unit of increase in body mass index, the CRF of women declined 0.20 metabolic equivalents (METs) (95% confidence interval, –0.21 to –0.19); that of men, 0.32 METs (–0.33 to –0.20). Current smokers of both sexes also had lower CRF (–0.29 METs [95% confidence interval, –0.40 to –0.19] for women and –0.41 METS [–0.44 to –0.38] for men). Cardiorespiratory fitness was positively associated with self-reported physical activity.

Conclusions  Cardiorespiratory fitness in men and women declines at a nonlinear rate that accelerates after 45 years of age. Maintaining a low BMI, being physically active, and not smoking are associated with higher CRF across the adult life span.

Author Affiliations: Department of Health and Human Performance, University of Houston, Houston, Texas (Dr Jackson); Departments of Exercise Science (Drs Sui and Blair) and Epidemiology and Biostatistics (Drs Hébert and Blair) and Statewide Cancer Prevention and Control Program (Dr Hébert), University of South Carolina, Columbia; and Pennington Biomedical Research Center, Baton Rouge, Louisiana (Dr Church).

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Arch Intern Med. 2009;169(19):1736.
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