Post 65, 15 minutes of physical activity prolongs life

A new study looking at the relationship between physical exercise and prevention of cardiovascular disease and death in people aged 65 and older has provided much needed evidence that even a small amount of exercise can protect against death.

…even those people doing only a fairly low level of physical activity each week, still had a 51 per cent lower risk of death than those doing the very minimum.

Like eating a diverse healthy diet (no, stay with me here!), it’s no secret that physical exercise is good for us.  For everything from preventing or managing a range of health problems and diseases – think, stroke, type 2 diabetes, depression, certain types of cancer, arthritis, reduced bone density, muscle strength and falls – to helping you get more sleep, have better social interactions and even more and better sex, exercise is key.

But less well understood are questions relating to the dose and type of exercise.  How much exercise is ‘enough’ to get the health benefits?  Are all forms of exercise created equal? And more importantly, how much of which types of exercise is enough for that murkily defined group known as ‘older people’?

For adults in the general population – usually defined as aged 18 to 64 or 65 – official physical activity guidelines recommend an exercise program of 30 minutes of moderate exercise at least five days a week (or 150 minutes per week) – an amount that has been shown by a large body of evidence to reduce the average risk of death by 30 per cent. However, evidence for the correlation between the level of physical activity and risk of death in older people (aged over 65) has not been so clear.

An evidence base

Enter a new French study however, whose results were presented earlier this month at the European Society of Cardiology’s EuroPRevent-2015 conference and have been picked up with great interest all around the world.

The study, known as the PROOF study, was led by Dr David Hupin from the Department of Clinical and Exercise Physiology at the University Hospital of St-Etienne-Lyon, in France. Dr Hupin’s team tracked more than 1000 French people who were aged 65 in 2001, and monitored their level of physical activity, as well as cardiovascular events and mortality, for 13 years.

Their levels of physical activity were monitored and categorised into different levels, ranging from very little physical activity, through the recommended activity levels for adults aged 18-64 (equivalent to brisk walking for 30 minutes a day or up to 150 minutes per week) and also beyond for those people who did a much greater amount of physical activity.

What did they find?  Well, around ten per cent of the participants died during the 13 year follow-up period.

BUT… the risk of death was found to be 57 per cent lower in those people whose activity level was equal to or higher than the 150 minutes per week recommended for adults aged 18-64.

What’s more, even those people doing only a fairly low level of physical activity each week, still had a 51 per cent lower risk of death than those doing the very minimum (presumably taking themselves to the bathroom, doing the odd spot of supermarket shopping or bringing the bins in.)

More good news

There were other significant findings too – notably that starting or restarting physical activity during retirement reduced the risk of death by two-thirds.  On the flip side, any reduction in activity – even in low levels of activity – exposed the elderly person to a higher risk of death.

Dr Hupin says the study demonstrates that physical activity in elderly people is indeed ‘protective’ against death and that this protection is ‘dose-dependent’.  This means that even a low level of exercise, below current adult recommendations, had some protective effect.

Considering physical activity guidelines for this older cohort, Dr Hupin said a simple rule is to aim for at least 15 minutes of physical activity for five days a week.

“This would be a suitable first target for the elderly,” he said.  “This could include brisk walking, cycling, swimming or gymnastics,” he suggested, “all possibly associated with leisure time physical activity or daily life activities.”

Dr Hupin emphasised that the widespread acceptance of this message would encourage more elderly people to include even “low doses” of physical activity in their usual daily activities, without experiencing high levels of fatigue or of pain.

“This message should be relayed by general practitioners, who play a key and essential role in promoting exercise behaviour in the elderly,” he said. “Even a little is good, and more may be better.”

NOTE for older Australians

Most of the official health guidelines on physical activity  – both here in Australia and overseas – refer to ‘adults’ who are generally defined as being aged 18 to 64.  In Australia we have different official guidelines for sub groups of children – children 0-5; 5-12; and 13-17 – but no differentiation among adults between the ages of 18 and 64.  There are no official guidelines for people aged 65 and over, however there are ‘recommendations’ which are entirely consistent with the findings of the PROOF study.