Activities of daily living increase survival among elderly

Published 2013-10-29 00:00. Updated 2014-10-29 10:26Denna sida på svenska

Daily exercise at home or some gardening can significantly cut the risk of a heart attack/stroke and prolong life among the 60+ age group, according to a new Swedish study published in the British Journal of Sports Medicine.

The research which was conducted at Karolinska Institutet and The Swedish School of Sport and Health Sciences show that these routine activities are as good as exercise, which is ideal for older people who don't often do that much formal exercise. Researchers base their findings on almost 4000 60 year olds in Stockholm, whose cardiovascular health was tracked for around 12.5 years.

At the start of the study, participants took part in a health check, which included information on lifestyle, such as diet, smoking, and alcohol intake, and how physically active they were in their daily life. They were asked how often they included a range of daily life activities, such as gardening, home exercise (DIY), car maintenance and blackberry picking, over the previous 12 months, as well as whether they took any intentional exercise.

Participants' cardiovascular health was assessed by means of lab tests and physical examinations, to check on blood fats, blood sugars, and blood clotting factor, high levels of which are linked to a raised heart attack and stroke risk. At the start of the study, those who had a generally active daily life had a much lower risk profile for cardiovascular problems, irrespective of how much formal exercise they took, than those with low levels of daily activity.

Smaller waists

The health profile included smaller waists, lower levels of potentially harmful blood fats, and in men lower glucose, insulin, and clotting factor levels. The same was true of those who did a lot of formal exercise, but who werent routinely physically active very often. Those who exercised regularly and were also often physically active had the lowest risk profile of all.

During the 12.5 year monitoring period, 476 of the participants had their first heart attack and 383 died from a variety of causes. The highest level of daily physical activity was associated with a 27% lower risk of a heart attack or stroke and a 30% reduced risk of early death from all causes, compared with the lowest level, irrespective of how much regular formal exercise was taken in addition.

"Our findings are particularly important for older adults, because individuals in this age group tend, compared to other age groups, to spend a relatively greater proportion of their daily routine activities as they often find it difficult to achieve recommended exercise intensity levels," says study author Elin Ekblom Bak, a Doctoral Student at Karolinska Institutet and The Swedish School of Sport and Health Sciences.

Energy expenditure

The researchers suggest that the biological explanations for their findings may lie in energy expenditure, as prolonged sitting drives down metabolic rate to the bare minimum, while standing up and physical activity increase it. Muscular contractions may also provide some clues. Sitting down doesn't require any muscle effort, which can disrupt the skeletal muscle's normal hormone production, with potential adverse effects on other body organs and tissues.

The research was funded by grants from The Swedish Order of Freemason; Grand Swedish Lounge, Stockholm County Council, the Swedish Heart-Lung Foundation, and the Swedish Research Council, and the Tornspiran Foundation. Study leader was Professor Mai-Lis Hellénius at the Department of Medicine, Solna, Karolinska Institutet. 


The importance of non-exercise physical activity for cardiovascular health and longevity.
Ekblom-Bak E, Ekblom B, Vikström M, de Faire U, Hellénius M
Br J Sports Med 2014 Feb;48(3):233-8