Physical activity attenuates the impact of poor physical, mental, and social health on total and cardiovascular mortality in older adults: a population-based prospective cohort study

PurposeTo examine the separate and joint associations of physical activity and levels of physical, mental, and social health with long-term all-cause and cardiovascular disease (CVD) mortality in older adults.MethodsA cohort of 4008 individuals representative of the non-institutionalized population of Spain aged 60years and older was analyzed. Information on physical activity was self-reported. Physical and mental health were assessed with the SF-36 questionnaire, and social health with a 4-item score on network structure and social engagement. Participants were categorized as being in a good, intermediate, or poor health according to tertiles of the score in each health dimension. Analyses were performed with Cox regression and adjusted for main confounders, including levels in the other two health dimensions.ResultsOver a median follow-up of 14 years, a total of 1811 deaths occurred, 674 due to CVD. Hazard ratios (95% confidence interval) for all-cause mortality were 1.35 (1.18-1.55), 1.18 (1.02-1.36), and 1.37 (1.18-1.58) for poor vs. good physical, mental, and social health, respectively (all p trend<0.001). Being physically active was associated with a 28% (15-39%), 31% (19-42%), and 19% (5-31%) lower all-cause mortality in participants with poor physical, mental, and social health, respectively. In each health dimension, physically active individuals with poor health showed a similar or lower all-cause mortality than those who had intermediate or good health but were physically inactive. Results for CVD mortality were similar to those for all-cause death.ConclusionsPhysical activity might attenuate the excess all-cause and CVD mortality associated with poor physical, mental, and social health.