title: Exercise adherence and 10-year mortality in chronically ill older adults.
abstract: 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.
authors.affiliation: Geriatric Research, Education and Clinical Center, Durham, North Carolina, USA. morey@geri.duke.edu
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Morey
authors.forename: Carl F
authors.initials: CF
authors.lastname: Pieper
authors.forename: Gail M
authors.initials: GM
authors.lastname: Crowley
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sullivan
authors.forename: Carmel M
authors.initials: CM
authors.lastname: Puglisi
mesh_terms: 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