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Exercise Adherence and 10-Year Mortality in Chronically Ill Older Adults

Authors

  • Miriam C. Morey PhD,

    1. Geriatric Research, Education and Clinical Center;
    2. Claude D. Pepper Older Americans Independence Center/Center on Aging,
    3. Department of Medicine,
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  • Carl F. Pieper DrPH,

    1. Geriatric Research, Education and Clinical Center;
    2. Claude D. Pepper Older Americans Independence Center/Center on Aging,
    3. Department of Biometry and Bioinformatics, and
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  • Gail M. Crowley,

    1. Department of Veterans Affairs Medical Center, Durham, North Carolina
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  • Rnc-Bsn,

    1. Geriatric Research, Education and Clinical Center;
    2. Claude D. Pepper Older Americans Independence Center/Center on Aging,
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  • Robert J. Sullivan Jr. MD,

    1. Geriatric Research, Education and Clinical Center;
    2. Claude D. Pepper Older Americans Independence Center/Center on Aging,
    3. Department of Medicine,
    4. Department of Biometry and Bioinformatics, and
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  • Carmel M. Puglisi MS

    1. Geriatric Research, Education and Clinical Center;
    2. Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
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Address correspondence to Miriam C. Morey, PhD, VA Medical Center, GRECC (182), 508 Fulton Street, Durham, NC 27705. E-mail: morey@geri.duke.edu

Abstract

OBJECTIVES: To compare mortality of adherents and nonadherents of an exercise program.

DESIGN: Prospective intervention study.

SETTING: Supervised geriatric fitness program called Gerofit.

PARTICIPANTS: One hundred thirty-five adults aged 65 and older who enrolled in Gerofit between January 1, 1990, and November 30, 1999. All participants had a baseline medical screen and exercise test. They were classified as adherent (n = 70) if they participated in Gerofit for more than 47 sessions or nonadherent (n = 65) if they did not complete 47 sessions within the first 6-month period.

INTERVENTION: Program participation was voluntary and consisted of aerobic, strength, flexibility, and balance exercises. The program met three times week for 90 minutes.

MEASUREMENTS: All-cause mortality.

RESULTS: Twenty-six deaths occurred within the 10-year follow-up period. Using proportional hazards, time to death was not related to adherence group. However, in multivariate analyses controlling for age, sex, race, baseline risk/health status, history of heart disease, cancer, diabetes mellitus, and baseline smoking status, there was significant group-by-time interaction (P = .004), indicating a crossover in mortality risk. The initial survival benefit observed in nonadherers changed over time, resulting in a long-term protective survival effect on mortality for the adherent group (hazard rate = 0.75, 95% confidence interval = 0.61–0.91 for the interaction term).

CONCLUSIONS: Older adults with chronic diseases experience a long-term beneficial mortality effect from participation in exercise programs. Physicians should strongly encourage their patients, including those with comorbidities, to maintain a regular exercise program.

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