A large study shows that even brief, irregular walking patterns, such as a few active days a week, can meaningfully lower the risk of death and heart disease in older women, challenging the 10,000-step myth.
Study: Association between frequency of meeting daily step thresholds and all-cause mortality and cardiovascular disease in older women. Image Credit: Edijs K / Shutterstock
A new study published in the British Journal of Sports Medicine reveals that older women who achieved at least 4000 steps per day for 1 to 2 days per week had a lower risk of all-cause mortality and cardiovascular disease.
Background
The transition to industrialized lifestyles, characterized by sedentary occupations, mechanized transport, and technological convenience, has led to a profound decline in daily physical activity, with step counts falling from approximately 15,000–20,000 to about 5,000 among older adults.
Such a lack of physical activity among older adults can contribute to physiological decline and increased disease vulnerability. A large pool of evidence suggests that regular physical activity is crucial for improving health and increasing longevity.
With increasingly low levels of physical activity in industrial populations, it is important to know how little physical activity older adults need to achieve appreciable health benefits.
The association between daily step count and risk of cardiovascular disease and mortality is well documented in the scientific literature. Given this association and the increasing availability and utility of wearable devices to measure step count, it would be essential to incorporate step metrics into future physical activity guidelines.
Recent meta-analytic evidence in The Lancet Public Health suggests that measurable health gains begin around 7,000 steps per day, reinforcing the current study’s message that meaningful protection occurs well below the popular but scientifically unsubstantiated 10,000-step target. Together, these findings challenge the long-held “10,000-step” myth and redefine what ‘enough movement’ means for everyday health. The current study aimed at investigating the impact of different daily step thresholds on the risk of cardiovascular disease and all-cause mortality in older women.
Study design
The study included a total of 13,547 women aged 45 years or above who were not diagnosed with cardiovascular disease or cancer. The participants were asked to wear a step-count device for 7 consecutive days and were subsequently followed for approximately 11 years to assess mortality and incident cardiovascular disease.
The study examined the impact of four-step thresholds. These thresholds were 4000, 5000, 6000, and 7000 steps per day. For the risk analysis, participants were categorized by daily pattern of meeting the thresholds: 0 days, 1 to 2 days, or 3 days or more.
The study population consisted primarily of older, white U.S. women with higher socioeconomic status, which the authors note may limit the generalizability of the findings.
Key findings
The study reported that 13% of participants died and 5.8% developed cardiovascular disease during the follow-up period of approximately 11 years.
The risk analysis revealed that women who achieved a daily threshold of 4000 or more steps for 1 to 2 days in a week had a 26% lower risk of death and 27% lower risk of cardiovascular disease compared to those who never achieved the specified threshold throughout the week.
Similarly, women who achieved a daily threshold of 4000 or more steps for 3 days or more in a week exhibited 40% and 27% lower risks of death and cardiovascular disease, respectively.
Overall, the study observed an inverse association between daily step count and mortality risk among older women. Specifically, the analysis showed further reduction in mortality risk with higher step thresholds (5000, 6000, or 7000 steps per day).
Notably, the observed associations were largely attenuated after adjustment for mean daily step counts, indicating that total step volume, rather than the frequency of meeting daily step thresholds, is important for risk reduction.
While the present analysis showed that step volume was the dominant driver of benefit, complementary research in hypertensive adults published in the European Journal of Preventive Cardiology found that walking faster and farther further reduces cardiovascular risk, suggesting that pace may still play a supportive role in higher-risk populations.
Study significance
The study demonstrates that a very modest level of daily physical activity can be associated with substantially lower risks of death and cardiovascular disease in older women. One important observation from the study is that the number of daily steps, rather than the daily patterns of reaching a particular step threshold, is associated with better health outcomes.
An important translational implication of these findings is that women can take steps in any preferred pattern to improve health. They can even choose a more variable, or irregular pattern of daily steps (“bunched pattern”) over a more consistent pattern (“slow and steady”) for health improvement.
Regarding daily patterns of physical activity, existing evidence links the “weekend warrior” pattern of exercise to lower chronic disease and mortality risk. The “weekend warrior” pattern refers to exercising only 1 to 2 days a week, preferably on weekends.
The current study selected 4000 steps per day as a lower threshold for reducing disease and mortality risk, based on prior evidence from this cohort showing that mortality risk begins to decline near 4000 steps and levels off between 7000 and 7500 steps per day. As discussed by the researchers, physical activity levels below 4000 daily steps initiate a cycle in which inadequate physical activity leads to increased frailty, which in turn leads to even less physical activity. Physical activity levels below a certain threshold may fail to initiate sufficient repair and maintenance mechanisms that slow down ageing and reduce disease vulnerability.
Parallel research from the University of Chicago shows that even modestly increasing walking cadence, about 14 steps per minute above one’s usual pace, can meaningfully improve physical function and help older adults maintain independence, further underscoring the broader benefits of movement beyond longevity alone.
Beyond cardiovascular and survival benefits, higher daily step counts have also been linked to improved mental health. A recent meta-analysis in JAMA Network Open found that every additional 1,000 steps per day reduces the risk of depression by approximately 9%, highlighting walking as an accessible and scalable tool for psychological well-being.
Complementary evidence from large-scale natural-experiment studies in Nature demonstrates that moving to more walkable cities increases daily step counts by about 1,100 steps, sustained for months, illustrating how urban design itself can enhance physical activity and magnify individual-level benefits.
Because this was an observational study, the findings show association rather than causation.
Overall, the study's findings highlight the importance of incorporating step metrics into future physical activity guidelines and into clinical and public health practice that specifically address the health and well-being of older women.