Article
The role of life-time physical activity for disability: Results from the KORA-Age Study
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Published: | September 20, 2011 |
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Background: Prevalence of disability and functional limitations in the aged is high in most industrialized countries and has been projected to rise dramatically. Consequently, prevention of disability is an important topic. Among other factors, the positive effect of physical activity on the incidence of disability is undisputable. Physical activity decreases the risk for many potentially disabling chronic diseases. Most studies, however, focused on the effects of late life exercise and physical fitness on morbidity and mortality.
There are only a few representative findings on the role of physical activity as a mid-life factor influencing late-life disability, none of them from Germany. Physical activity acts here as a case in point for an alterable mid-life factor, being accessible to prevention and being a well-established predictor for other health related outcomes. The aim of this study was to determine the association between mid-life physical activity and late-life disability in a representative sample of aged persons.
Material and Methods: The KORA (Kooperative Gesundheitsforschung in der Region Augsburg)-Age study is a follow up of the MONICA/KORA S1 – S4 surveys, 4 independent cross-sectional population-based studies in the region of Augsburg, and conducted in five year intervals (1984/85 till1999/2001). The KORA-Age cohort comprises participants of the MONICA/KORA surveys aged 65 years and above. Disability was assessed by telephone interview in 2009 (follow-up) with the Health Assessment Questionnaire Disability Index (HAQ-DI). Minimal disability was defined as HAQ-DI > 0. Physical activity and covariates were assessed at the surveys (baseline). Participants were stratified for age at baseline. We applied logistic regression models within each stratum adjusted for sex, age at follow-up, BMI, self-rated health, education and comorbidities.
Results: We analyzed a total of 4127 persons (51.2% female) with a mean age of 56.7 (SD=8.1) at baseline and 73.6 years (SD=6.1) at follow-up. Mean follow-up time was 16.9 years (SD=5.7). Minimal disability was present in 44.7% of all persons at follow-up. Having been active at the 50th decade decreased the risk for later disability (OR=0.76, CI=[0.61; 0.95]); a similar association was seen for persons age 60 years and above at baseline (OR=0.70, CI=[0.55; 0.88]). We could not show an effect in the stratum 50 years or younger (OR=1.05, CI=[0.77; 1.43]).
Discussion: Mid-life physical activity might postpone disability. This effect could be shown in individuals being physically active at the age of 50 and over. As for those below 50, study design and length of follow-up have to be discussed.