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  • It's Never Too Late: Study Finds Beginning PA Later in Life Reduces Mortality Risk Nearly as Much as Remaining Active From Adolescence

    You've probably experienced it before: your 40-something patient thinks that after 4 decades of relative physical inactivity, there's no point in starting now.

    Tell your patient to think again. A recent study that tracked leisure time physical activity (LTPA) levels of more than 300,000 adults for as long as 46 years concludes that middle-aged adults who take up LTPA for the first time reduce risk of all-cause mortality by nearly as much as adults who've remained active since adolescence. And that risk reduction extends to deaths related to cardiovascular disease (CVD) and cancer.

    The study analyzed data from an AARP-sponsored diet and health survey conducted from 1995 to 1996 in relation to mortality information from the National Death Index. The survey, administered to participants aged 50–71, asked respondents to identify levels of regular moderate-to-vigorous LTPA at various points in their lives—at age 15-18, 19-29, 35-39, and during the previous 10 years. A little more than 20 years later (2017-2018), researchers paired respondents with mortality reports to gauge the effects of LTPA on risk of death. Results were published in JAMA Network Open.

    Authors of the study had a sensible-sounding hypothesis—that participants who reported more LTPA in adolescence, and then maintained higher levels of LTPA throughout adulthood, would be found to have lower risk of all-cause, CVD, and cancer-related mortality. They were right—but there was more to the story.

    As they predicted, researchers found that compared with a control group that reported low levels of LTPA during their lifetimes (fewer than 60 minutes per week), participants maintaining moderate to high amounts of LTPA (2-8 hours per week) from age 15 to 40 or older lowered their risk of death, reducing all-cause mortality risk by 29% to 36%, and dropping CVD and cancer-related death risk by an average of 38% and 18%, respectively.

    To the researchers' surprise, however, adults who reported low levels of LTPA in adolescence but increased those levels after age 30 generated comparable reductions in risk of death compared with control—a drop of 35% for all-cause mortality, and reductions in CVD and cancer-related mortality of 43% and 16%, respectively.

    "We anticipated that participants who maintained the highest levels of activity throughout adulthood would be at lowest risk and were thus surprised to find that increasing activity early or late in adulthood was associated with comparable benefits," authors write. "These benefits held similarly for men and women…and were independent of changes in BMI over time."

    Researchers also found that respondents who reported high levels of LTPA in early adulthood but lower levels at 40 or older "appeared to have little all-cause or CVD-related mortality protection in midlife."

    Authors say their study supports earlier research into the benefits of PA in midlife, but they believe theirs is the first to look at LTPA over a longer period of time and to track increased or decreased levels of LTPA at multiple points. The results echo those of another recent study linking higher rates of PA midlife to lowered risk of Alzheimer's disease and other dementia in later years.

    [Editor's note: Visit APTA's prevention and wellness webpage for resources on how physical therapists and physical therapist assistants can help individuals become more physically active, and share the latest PA information from APTA's consumer-focused MoveForwardPT.com with your patients, clients, and others interested in the benefits of exercise and movement. Want to connect with others interested in physical therapy's role in improving health? Join APTA's Council on Prevention, Health Promotion, and Wellness. The association is also an organizational partner in the National Physical Activity Plan Alliance, and has a seat on its board of directors.]

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.