Physical activity and physical fitness in prediction of all-cause mortality and age at death in European extinct cohorts of middle-aged men followed for 60 years.

Aims: A study of the power of physical activity (Phyac) and physical fitness (Fitscore) in predicting very long-term all-cause mortality and age at death (AD) is missing.

Methods and results: A total of 5482 middle-aged men were examined with measurement of several risk factors and followed for 60 years until the virtual extinction of cohorts. Phyac in three classes was estimated from their type of work while Fitscore was derived from the linear combinations of levels of arm circumference, heart rate, and vital capacity computed as a factor score by principal components analysis. The predictive power of these characteristics (adjusted for five traditional cardiovascular risk factors) was made by Cox models (for all-cause mortality) and multiple linear regression models (for AD). Single levels of the three indicators of fitness were highly related to the three levels of Phyac and of Fitscore. High levels of both Phyac and of Fitscore forced into the same models were associated with lower all-cause mortality and higher AD. The predictive power of Fitscore was systematically better than that of Phyac. Hazard ratios (high vs. low) for all-cause mortality were 0.85 (Phyac) and 0.70 (Fitscore). The coefficients (all significant) were 2.25 years (Phyac) and 3.79 of AD by Fitscore. Fitscore was independently and significantly predictive of all-cause mortality for both the first and second 30-year follow-up periods.

Conclusion: Phyac and Fitscore are related, and both showed important predictive power for all-cause mortality and AD. The role of Fitscore was more powerful, and both characteristics seem to be expressions of health status.