Daily activity energy expenditure and mortality among older adults
Abstract
CONTEXT: Exercise is associated with mortality benefits but simply expending energy through any activity in an individual's free-living environment may confer survival advantages. OBJECTIVE: To determine whether free-living activity energy expenditure is associated with all-cause mortality among older adults. DESIGN, SETTING, AND PARTICIPANTS: Free-living activity energy expenditure was assessed in 302 high-functioning, community-dwelling older adults (aged 70-82 years). Total energy expenditure was assessed over 2 weeks using doubly labeled water. Resting metabolic rate was measured using indirect calorimetry and the thermic effect of meals was estimated at 10% of total energy expenditure. Free-living activity energy expenditure was calculated as: (total energy expenditure x 0.90) - resting metabolic rate. Participants were followed up over a mean of 6.15 years (1998-2006). MAIN OUTCOME MEASURES: Free-living activity energy expenditure (3 tertiles: low, <521 kcal/d; middle, 521-770 kcal/d; high, >770 kcal/d) and all-cause mortality. RESULTS: Fifty-five participants (18.2%) died during follow-up. As a continuous risk factor, an SD increase in free-living activity energy expenditure (287 kcal/d) was associated with a 32% lower risk of mortality after adjusting for age, sex, race, study site, weight, height, percentage of body fat, and sleep duration (hazard ratio, 0.68; 95% confidence interval, 0.48-0.96). Using the same adjustments, individuals in the highest tertile of free-living activity energy expenditure were at a significantly lower mortality risk compared with the lowest tertile (hazard ratio, 0.31; 95% confidence interval, 0.14-0.69). Absolute risk of death was 12.1% in the highest tertile of activity energy expenditure vs 24.7% in the lowest tertile; absolute risks were similar to these for tertiles of physical activity level. The effect of free-living activity energy expenditure changed little after further adjustment for self-rated health, education, prevalent health conditions, and smoking behavior. According to self-reports, individuals expending higher levels of free-living activity energy were more likely to work for pay (P = .004) and climb stairs (P = .01) but self-reported high-intensity exercise, walking for exercise, walking other than for exercise, volunteering, and caregiving did not differ significantly across the activity energy expenditure tertiles. CONCLUSIONS: Objectively measured free-living activity energy expenditure was strongly associated with lower risk of mortality in healthy older adults. Simply expending energy through any activity may influence survival in older adults.
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We were able to recruit a patient population that is very inactive (physical activity level <1.4).
“We were able to recruit a patient population that is very inactive (physical activity level, , 1.4) (28, 51)”
From Health Coaching and Chronic Obstructive Pulmonary Disease Rehospitalization: A Randomized Study (2016) · cites this paper as [51]
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- Authors
- Manini, T. M., Everhart, J. E., Patel, K. V., Schoeller, D. A., Colbert, L. H., Visser, M., Tylavsky, F., Bauer, D. C., Goodpaster, B. H., & Harris, T. B.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Manini, Todd M.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2006-07-12
- Volume
- 296
- Issue
- 2
- Pages
- 171
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2163659407
- Cited by
- 598
- References
- 37
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 9 · 2023: 17 · 2022: 18 · 2021: 15 · 2020: 26 · 2019: 23 · 2018: 23 · 2017: 31 · 2016: 33 · 2015: 32 · 2014: 40 · 2013: 33 · 2012: 50
- FWCI
- 28.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging (N01‐AG‐6–2101, N01AG62106, N01-AG-62103)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- all-cause mortality, older adults, physical activity, energy expenditure, resting metabolic rate, community-dwelling older adults, walking, stair climbing, occupational physical activity, mortality risk factors, self-rated health, socioeconomic status, smoking, sleep duration, body fat percentage
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Basal Metabolism, Energy Metabolism, Female, Humans, Male, Mortality, Motor Activity, Risk, Exercise
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