The relation between non-occupational physical activity and years lived with and without disability

Objectives: The effects of non-occupational physical activity were assessed on the number of years lived with and without disability between age 50 and 80 years. Methods: Using the GLOBE study and the Longitudinal Study of Aging, multi-state life tables were constructed yielding the number of years with and without disability between age 50 and 80 years. To obtain life tables by level of physical activity (low, moderate, high), hazard ratios were derived for different physical activity levels per transition (non-disabled to disabled, non-disabled to death, disabled to non-disabled, disabled to death) adjusted for age, sex and confounders. Results: Moderate, compared to low non-occupational physical activity reduced incidence of disability (HR 0.66, 95% CI 0.51 to 0.86), increased recovery (HR 1.95, 95% CI 1.32 to 2.87), and represents a gain of disability-free years and a loss of years with disability (male 3.1 and 1.2; female 4.0 and 2.8 years). Performing high levels of non-occupational physical activity further reduced incidence, and showed a higher gain in disability-free years (male 4.1; female 4.7), but a similar reduction in years with disability. Conclusion: Among 50–80-year-olds promoting physical activity is a fundamental factor to achieve healthy ageing. In 2025 1.2 billion people worldwide will be aged 60 years and over.1 Living longer is a societal achievement, but also a source of concern as prevalence of major chronic diseases and disability increase with age. A rising share of older age groups in the population will increase the burden of morbidity and will put an upward pressure on costs. The number of older people with severe disability may be 40% to 75% higher by 2030 because of population ageing.2 Health and long-term care spending is projected to almost double by 2050 across members of the Organization of Economic Cooperation and Development (OECD). In the approach of "healthy" ageing, however, these consequences might be mitigated. Physical activity is an important candidate tool to achieve healthy ageing. Physical activity reduces mortality,3 extends life expectancy4 and delays the onset of chronic diseases, including cardiovascular disease (CVD), cancer and diabetes.3–5 Increasing evidence exists that physical activity also delays the onset of disability,6–22 and increases the chances8 15 22–24 and duration of recovery from disability.23 Although an active lifestyle has been found to increase life expectancy in some studies and to reduce disability in others, its overall effect on health is still largely unknown. There are limited data about the effects of physical activity on the number of years with and without disability and these effects are not easy to predict. The effects of risk factors for both disability and death, such as physical activity, can follow different directions.25 Therefore, it is unclear whether the extra years gained by engaging in a physically active lifestyle will be free of disability or will add to the time lived with disability. The aim of this study is to assess the effects of non-occupational physical activity on life expectancy and the number of years lived with and without disability in 50–80-year-olds.

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