What does fitness in midlife mean for depression, cardiovascular disease later in life?

Bottom Line: A high level of fitness in midlife was associated with a lower risk of depression after age 65 and a lower risk of cardiovascular death, including after a diagnosis of depression.

Why The Research Is Interesting: Fitness, a risk factor that can be changed, has an association with chronic diseases, cardiovascular disease events and death. How fitness in mid-life is associated with later-life depression and the risk of death from cardiovascular disease after a depression diagnosis is not well understood.

Who and When: 17,989 generally healthy men and women (average age 50); they visited a clinic for a preventive medicine exam at midlife (data were collected from 1971 through 2009) and they were eligible for Medicare from 1999 to 2010

What (Study Interventions and Outcomes): Midlife fitness estimated from treadmill exercise test results (exposures); depression diagnoses from Medicare claims files and CVD mortality from National Death Index records (outcomes)

How (Study Design):  This was an observational study. Researchers were not intervening for purposes of the study and cannot control for all the natural differences that could explain the study results.

Authors: Benjamin L. Willis, M.D., M.P.H., of the Cooper Institute, Dallas, Texas, and coauthors

Study Limitations: Diagnoses came from Medicare claims data; the severity of depression could not be determined; and authors cannot eliminate the possibility of depression and CVD leading to lower fitness levels

Study Conclusions: Health care professionals should consider fitness and physical activity as part of overall preventive care to promote healthy aging.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/ jamapsychiatry.2018.1467)

Editor's Note: The article includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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