Exercise adherence and 10-year mortality in chronically ill older adults.
OBJECTIVE
To compare mortality of adherents and nonadherents of an exercise program.


METHODS
Prospective intervention study.


METHODS
Supervised geriatric fitness program called Gerofit.


METHODS
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.


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


METHODS
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.
Morey
Miriam C
MC
Geriatric Research, Education and Clinical Center, Durham, North Carolina, USA. morey@geri.duke.edu
Pieper
Carl F
CF
Crowley
Gail M
GM
Sullivan
Robert J
RJ
Puglisi
Carmel M
CM
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000401:mortality*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D010352:Patient Dropouts; D011446:Prospective Studies