Physical activity and cause-specific mortality: the Rotterdam Study
Open accessAbstract
Background: Physical activity (PA) is associated with lower risk for all-cause mortality. However, in elderly people, it remains unknown which types of PA are associated with mortality and whether the association between PA and mortality differs by cause of death. Methods: We assessed the association of total PA, walking, cycling, domestic work, sports and gardening with all-cause mortality, and the association of total PA with cause-specific mortality, using Cox proportional hazard models among 7225 older adults (mean age: 70 years) from the prospective population-based Rotterdam Study. Deaths were classified as due to cardiovascular diseases (CVDs), cancer, infections, external causes, dementia, chronic lung diseases or other causes. Activities were categorized into tertiles (lowest tertile as reference). To account for the possibility of reverse causation, we excluded the first 5 and 10 years of follow-up. Results: Over a median of 13.1 years of follow-up (interquartile range: 8.4-14.6 years), 3261 participants died. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) associated with high total PA compared with low were 0.69 (0.63, 0.75), 0.69 (0.58, 0.81), 0.44 (0.27, 0.71), 0.47 (0.32, 0.71) and 0.56 (0.46, 0.69) for mortality from all causes, CVDs, chronic lung diseases, infections and other causes, respectively. With longer exclusion times, the strength of these associations was attenuated. All PA types were associated with lower all-cause mortality risk. Conclusions: Engagement in higher PA levels was associated with lower risk of mortality from CVDs, chronic lung diseases, infections and other causes. Participating in any PA might reduce mortality risk in older adults.
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Cites
2011 Compendium of Physical Activities: A Second Update of Codes and MET Values
AINSWORTH, B. E., HASKELL, W. L., HERRMANN, S. D., MECKES, N., BASSETT, D. R., TUDOR-LOCKE, C., GREER, J. L., VEZINA, J., WHITT-GLOVER, M. C., & LEON, A. S. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31821ece12 · Cited by 6,317 · see citing works
Arem, H., Moore, S. C., Patel, A., Hartge, P., Berrington de Gonzalez, A., Visvanathan, K., Campbell, P. T., Freedman, M., Weiderpass, E., Adami, H. O., et al. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.0533 · Cited by 1,498 · see citing works
Kyu, H. H., Bachman, V. F., Alexander, L. T., Mumford, J. E., Afshin, A., Estep, K., Veerman, J. L., Delwiche, K., Iannarone, M. L., Moyer, M. L., et al. (2016) · BMJ · doi:10.1136/bmj.i3857 · Cited by 1,272 · see citing works
Garcia-Aymerich, J., Lange, P., Benet, M., Schnohr, P., & Anto, J. M. (2006) · Thorax · doi:10.1136/thx.2006.060145 · Cited by 1,113 · see citing works
Andersen, L. B., Schnohr, P., Schroll, M., & Hein, H. O. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.11.1621 · Cited by 1,035 · see citing works
Samitz, G., Egger, M., & Zwahlen, M. (2011) · International Journal of Epidemiology · doi:10.1093/ije/dyr112 · Cited by 836 · see citing works
Hupin, D., Roche, F., Gremeaux, V., Chatard, J.-C., Oriol, M., Gaspoz, J.-M., Barthélémy, J.-C., & Edouard, P. (2015) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-094306 · Cited by 565 · see citing works
Celis-Morales, C. A., Lyall, D. M., Welsh, P. I., Anderson, J. J., Steell, L., Guo, Y., Maldonado, R., Mackay, D., Pell, J. P., Sattar, N. A., et al. (2017) · BMJ · doi:10.1136/bmj.j1456 · Cited by 523 · see citing works
The Rotterdam Study: 2018 update on objectives, design and main results
Ikram, M. A., Brusselle, G., Murad, S. D., van Duijn, C. M., Franco, O. H., Goedegebure, A., Klaver, C. C. W., Nijsten, T. E. C., Peeters, R. P., Stricker, B. H. C., et al. (2017) · European Journal of Epidemiology · doi:10.1007/s10654-017-0321-4 · Cited by 431 · see citing works
Self-citationCaspersen, C. J., Bloemberg, B. P. M., Saris, W. H. M., Merritt, R. K., & Kromhout, D. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115821 · Cited by 331 · see citing works
Methods of data collection and definitions of cardiac outcomes in the Rotterdam Study
Leening, M. J. G., Kavousi, M., Heeringa, J., van Rooij, F. J. A., Heemst, J. V., Deckers, J. W., Mattace-Raso, F. U. S., Ziere, G. J., Albert Hofman, D., Stricker, B. H. C., et al. (2012) · European Journal of Epidemiology · doi:10.1007/s10654-012-9668-8 · Cited by 245 · see citing works
Oja, P., Kelly, P., Pedisic, Z., Titze, S., Bauman, A., Foster, C., Hamer, M., Hillsdon, M., & Stamatakis, E. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096822 · Cited by 212 · see citing works
Andersen, Z. J., de Nazelle, A. J., Méndez, M. A., García‐Aymerich, J., Hertel, O., Tjønneland, A. M., Overvad, K., Raaschou‐Nielsen, O., & Nieuwenhuijsen, M. J. (2015) · Environmental Health Perspectives · doi:10.1289/ehp.1408698 · Cited by 209 · see citing works
Association between domains of physical activity and all-cause, cardiovascular and cancer mortality
Autenrieth, C. S., Baumert, J. J., Baumeister, S. E., Fischer, B., Peters, A., Döring, A., & Thorand, B. (2010) · European Journal of Epidemiology · doi:10.1007/s10654-010-9517-6 · Cited by 196 · see citing works
Clague, J., & Bernstein, L. (2012) · Current Oncology Reports · doi:10.1007/s11912-012-0265-5 · Cited by 151 · see citing works
Holtermann, A., Marott, J. L., Gyntelberg, F., Søgaard, K., Suadicani, P., Mortensen, O. S., Prescott, E., & Schnohr, P. (2012) · BMJ Open · doi:10.1136/bmjopen-2011-000556 · Cited by 145 · see citing works
Dong, L. M., Block, G., & Mandel, S. (2004) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-1-4 · Cited by 134 · see citing works
Sabia, S., Dugravot, A., Mika Kivimaki, B., Brunner, E. J., Shipley, M. J., & Singh‐Manoux, A. (2011) · American Journal of Public Health · doi:10.2105/ajph.2011.300257 · Cited by 117 · see citing works
Association of Physical Activity by Type and Intensity With Digestive System Cancer Risk
Keum, N., Bao, Y., Smith‐Warner, S. A., Orav, E. J., Wu, K., Fuchs, C. S., & Giovannucci, E. L. (2016) · JAMA Oncology · doi:10.1001/jamaoncol.2016.0740 · Cited by 116 · see citing works
Relationship between Subdomains of Total Physical Activity and Mortality
Besson, H., Ekelund, U., Brage, S., Luben, R., Bingham, S. A., Khaw, K., & Wareham, N. J. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318180bcad · Cited by 106 · see citing works
Leisure Time Physical Activity and Mortality
Johnsen, N. F., Ekblond, A., Thomsen, B. L., Overvad, K., & Tjønneland, A. M. (2013) · Epidemiology · doi:10.1097/ede.0b013e31829e3dda · Cited by 62 · see citing works
Impact of different domains of physical activity on cause-specific mortality: A longitudinal study
Wanner, M., Tarnutzer, S., Martin, B. W., Braun, J., Rohrmann, S., Bopp, M., & Faeh, D. (2014) · Preventive Medicine · doi:10.1016/j.ypmed.2014.01.025 · Cited by 60 · see citing works
Li, Y., Gu, M., Jing, F., Cai, S., Bao, C., Wang, J., Jin, M., & Chen, K. (2015) · International Journal of Cancer · doi:10.1002/ijc.29828 · Cited by 60 · see citing works
Koolhaas, C. M., Dhana, K., Golubic, R., Schoufour, J. D., Hofman, A., van Rooij, F. J. A., & Franco, O. H. (2016) · American Journal of Epidemiology · doi:10.1093/aje/kwv244 · Cited by 60 · see citing works
Self-citationPäivi, M., Hirvensalo, M. H., & Parkatti, T. (2010) · Journal of Aging Research · doi:10.4061/2010/174290 · Cited by 50 · see citing works
VALIDATION OF THE ZUTPHEN PHYSICAL ACTIVITY QUESTIONAIRE FOR THE ELDERLY WITH DOUBLY LABELED WATER
Westerturp, K. R., Saris, W. H. M., Bloemberg, B., Kempen, K. P., Caspersen, C. J., & Kromhout, D. (1992) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199205001-00404 · Cited by 42 · see citing works
Bone Mineral Density and Chronic Lung Disease Mortality: The Rotterdam Study
Campos‐Obando, N., Castano-Betancourt, M. C., Oei, L., Franco, O. H., Stricker, B. H. C., Brusselle, G., Lahousse, L., Albert Hofman, D., Tiemeier, H. W., Rivadeneira, F., et al. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-3819 · Cited by 29 · see citing works
Self-citationRosness, T. A., Strand, B. H., Bergem, A. L. M., Engedal, K., & Bjertness, E. (2014) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000367938 · Cited by 18 · see citing works
Kopperstad, Ø., Skogen, J. C., Sivertsen, B., Tell, G. S., & Sæther, S. M. M. (2017) · PLoS ONE · doi:10.1371/journal.pone.0172932 · Cited by 18 · see citing works
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Sarcopenia and Sarcopenic Obesity and Mortality Among Older People
Benz, E., Pinel, A., Guillet, C., Capel, F., Pereira, B., De Antonio, M., Pouget, M., Cruz-Jentoft, A. J., Eglseer, D., Topinkova, E., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.3604 · Cited by 261 · see citing works
Self-citationJung, I., Han, K.-D., Moon, S. J., Kwon, H., Park, S. E., Rhee, E.-J., & Lee, W.-Y. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.110819 · Cited by 4 · see citing works
Sarcopenic Obesity Phenotype Index (SOP <i>i</i> ): A Population‐Based Study
Benz, E., Pinel, A., Guillet, C., Capel, F., Pereira, B., Rizopoulos, D., Cruz‐Jentoft, A. J., Eglseer, D., Topinkova, E., Barazzoni, R., et al. (2025) · Journal of Cachexia, Sarcopenia and Muscle · doi:10.1002/jcsm.70099 · Cited by 2 · see citing works
“…of the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire and expressed in metabolic equivalent of task (MET)- hours per week) [37], total calorie intake, fibre intake, fat intake, carbohydrate intake, daily protein intake (dichotomized at 1.0 g/kg) (calculated from…”
InfluentialSelf-citation
- Authors
- Koolhaas, C. M., Dhana, K., Schoufour, J. D., Lahousse, L., van Rooij, F. J. A., Ikram, M. A., Brusselle, G., Tiemeier, H., & Franco, O. H.
- Affiliations
- Erasmus MC (NL)
- Harvard University (US)
- Ghent University Hospital (BE)
- Department of Epidemiology, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
- Corresponding author
- Koolhaas, Chantal M
- ORCID
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-04-16
- Volume
- 47
- Issue
- 5
- Pages
- 1705-1713
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2799472176
- Cited by
- 33
- References
- 29
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 8 · 2019: 2 · 2018: 1
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Funders
- Netherlands Organisation for Scientific Research (017.106.370)
- Netherlands Organisation for the Health Research and Development
- Research Institute for Diseases in the Elderly
- Ministry of Education
- Culture and Science
- Ministry for Health
- Welfare and Sports
- European Commission
- Municipality of Rotterdam
- Nestlé Nutrition
- Metagenics Inc
- Postdoctoral Fellow of the Research Foundation - Flanders
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- physical activity, cause-specific mortality, all-cause mortality, older adults, cardiovascular mortality, infection-related mortality, walking, cycling, domestic work, sport, gardening, reverse causality
- MeSH terms
- Aged, Aged, 80 and over, Cardiovascular Diseases, Female, Humans, Infections, Lung Diseases, Male, Middle Aged, Neoplasms, Netherlands, Prospective Studies, Risk Factors, Time Factors, Exercise, Multivariate Analysis, Proportional Hazards Models
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