Bottom Line: A high level of fitness in midlife was associated with a lower risk of depression after age 65 and a lower risk of cardiovascular death, including after a diagnosis of depression.
Why The Research Is Interesting: Fitness, a risk factor that can be changed, has an association with chronic diseases, cardiovascular disease events and death. How fitness in mid-life is associated with later-life depression and the risk of death from cardiovascular disease after a depression diagnosis is not well understood.
Who and When: 17,989 generally healthy men and women (average age 50); they visited a clinic for a preventive medicine exam at midlife (data were collected from 1971 through 2009) and they were eligible for Medicare from 1999 to 2010
What (Study Interventions and Outcomes): Midlife fitness estimated from treadmill exercise test results (exposures); depression diagnoses from Medicare claims files and CVD mortality from National Death Index records (outcomes)
How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control for all the natural differences that could explain the study results.
Authors: Benjamin L. Willis, M.D., M.P.H., of the Cooper Institute, Dallas, Texas, and coauthors
Study Limitations: Diagnoses came from Medicare claims data; the severity of depression could not be determined; and authors cannot eliminate the possibility of depression and CVD leading to lower fitness levels
Study Conclusions: Health care professionals should consider fitness and physical activity as part of overall preventive care to promote healthy aging.