By Lucy Piper
Participation in a long-term moderately intense activity programme has failed to reduce cardiovascular disease (CVD) events in older adults, findings from the LIFE Study show.
This was despite the intervention's previously documented ability to prevent mobility disability, note the researchers led by Anne Newman (University of Pittsburgh, Pennsylvania, USA).
The physical activity intervention, which meets current guidelines for older adults, involved at least 150 minutes per week of moderate-intensity aerobic activity, primarily from walking, with weight training.
The 818 people aged 70 to 89 years who participated in this activity for an average of 2.6 years were no less likely to experience a new CVD event than the 817 individuals participating in a 'successful aging' intervention consisting of weekly health education sessions for 6 months and monthly thereafter, at a rate of 14.8% versus 13.8%.
Even when the outcome was limited to a combination of myocardial infarction, stroke or cardiovascular death, the rates remained similar, at 4.6% and 4.5%, respectively.
The participants were predominantly women, at 67%, and of non-Latino White ethnicity. All of them had a Short Physical Performance Battery (SPPB) score of 9 or below but were still able to walk 400 m.
The lack of benefit was seen for most subgroups, including the one-third of participants with prevalent CVD at baseline.
Indeed, the researchers suggest in JAMA Cardiology that this high burden of CVD may have made it "too late for this high-risk group to benefit".
Evidence of some benefit was seen for individuals with poorer physical performance at baseline (SPPB score below 8), who had a 14.2% CVD event rate with physical activity versus 17.7% with successful aging. This compared with respective rates of 15.3% and 10.5% among those with SPPB scores of 8 or 9.
However, there was no association with the restricted combined outcome and further evaluations failed to provide an explanation for the higher event rate with physical activity in less frail individuals.
In addition to the high burden of CVD, suboptimal dose, duration or intensity of activity may explain in part the lack of reduction in CVD events, Newman and colleagues suggest.
They believe that "the benefits of activity appear to be primarily reduced mobility disability and perhaps improved cognition."
They stress that "[t]he lack of association between increased [physical activity] and reduced CVD found here should not detract from efforts to promote a program of sustained walking and weight training in frail older adults."
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