bearing blog: A little middle-aged motivation for you.

The NYT "Well Blog" describes a study that's good news for those of us who are committed to staying fit in middle age -- or who have time to practice better habits between now and then.

[W]e are spending more years living with chronic disease and ill health — not the outcome that most of us would hope for from a prolonged life span.

But a notable new study published last week in Archives of Internal Medicine suggests that a little advance planning could change that prospect. Being or becoming fit in middle age, the study found, even if you haven’t previously bothered with exercise, appears to reshape the landscape of aging.

Here's the deal, as best as I can figure it out: Waaaay back in 1970, a group of more than 18,000 healthy, chronic-disease-free middle-aged men and women (average age: 49) had visited a clinic for a treadmill test to determine their aerobic fitness.

According to the blog, the data was still around in recent years, when researchers used it to divide the group into five "fitness categories" based on the results of that long-ago treadmill test. (Most of them fell in the "least-fit" category.)

Then, in a first-of-its-kind data comparison, the researchers checked the same individuals’ Medicare claim records (with permission) from 1999 through 2009, by which time most of the participants were in their 70s or 80s.

What they found was that those adults who had been the least fit at the time of their middle-age checkup also were the most likely to have developed any of eight serious or chronic conditions early in the aging process. These include heart disease, diabetes, Alzheimer’s, and colon or lung cancer.

The adults who’d been the most fit in their 40s and 50s often developed many of the same conditions, but notably their maladies appeared significantly later in life than for the less fit. Typically, the most aerobically fit people lived with chronic illnesses in the final five years of their lives, instead of the final 10, 15 or even 20 years.

This is pretty good news, especially if you're

(a) already a fit middle-aged person,
(b) not yet middle-aged, or
(c) just beginning middle age and thinking about developing good habits.

Moving from the least-fit to the second-least-fit category appears to have the strongest effect. If that's so, then going from total couch potato to not-quite-completely-a-couch-potato might make a big difference in how many years you spend as an infirm adult.

The aerobic fitness level at that middle-aged checkup did not affect lifespan nearly as strongly as it affected quality of life. It "compressed" the years of infirmity. To put it bluntly, this suggests that a public health effort which managed to encourage activity in the middle age years could well pay off in long-term health care costs.

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Of course, this might not demonstrate a causal relationship. Even though all these adults were healthy and free of chronic disease in 1970, maybe the least-fit ones were unfit because of some underlying, deep condition that also caused them to develop chronic disease sooner than the fitter ones. Maybe a choice to become fitter wouldn't have changed that.

But then again, maybe it would have. Maybe individuals who decided to become fitter would have paid more attention to the signals their body sent them, and would have detected problems earlier. Maybe a habit of exercise would have given them confidence to change other habits. Maybe getting out of the house more would have improved their mental health. We really don't know.

I think this is really good news for my readers out there, most of whom are women in their childbearing years, and who don't see much concrete motivation to work on fitness habits. You've got time, folks.

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I would be interested in knowing more details about the age range and about how the individuals were divided into fitness quintiles, but don't have quick and easy access to the journal.

(HINT HINT HINT, those of you with access to Arch. Intern. Med. I believe this is the link.)