Survival of the fittest? Peak oxygen uptake and all-cause mortality among older adults in Norway

Atefe R Tari; Daniel E Brissach; Emma M L Ingeström; Javaid Nauman; Tristan Tyrell; Carl Foster; Kimberley Radtke; John P Porcari; Stian Lydersen; Leonard A Kaminsky; Jonathan Myers; Tara L Walker; Jeff S Coombes; Dorthe Stensvold; Ulrik Wisløff

doi:10.1016/j.pcad.2024.11.004

Survival of the fittest? Peak oxygen uptake and all-cause mortality among older adults in Norway

Prog Cardiovasc Dis. 2024 Dec 4:S0033-0620(24)00169-5. doi: 10.1016/j.pcad.2024.11.004. Online ahead of print.

Authors

Affiliations

¹ Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neurology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
² Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
³ Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
⁴ University of Wisconsin-La Crosse, La Crosse, WI, USA.
⁵ Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, NTNU-Norwegian University of Science and Technology, Trondheim, Norway.
⁶ Fisher Institute of Health and Well-Being, Clinical Exercise Physiology Program, Ball State University, Muncie, IN, USA.
⁷ Division of Cardiology, Veterans Affairs Palo Alto Healthcare System and Stanford University, CA, USA.
⁸ Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, The University of Queensland, Brisbane, Australia.
⁹ Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.
¹⁰ Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia. Electronic address: [email protected].

PMID: 39638222
DOI: 10.1016/j.pcad.2024.11.004

Abstract

Objective: To determine the cardiorespiratory fitness (CRF) levels needed to avoid the Grim Reaper (Death) among older adults. We hypothesized that an above average peak oxygen uptake (VO_2peak) is needed for 70-77-year-old men and women to delay the encounter with Death.

Design: Prospective cohort study.

Setting: General population of older adults in Norway.

Participants: 788 women and 777 men aged 70-77 years.

Intervention: Clinical assessments, including a test of VO_2peak. Participants were categorised based on their baseline VO_2peak and changes after 1 year. This study explored associations between VO_2peak and 5-year all-cause mortality using Cox proportional hazard models.

Main outcome measure: All-cause mortality.

Results: Death caught up with 5.3 % of men and 3.7 % of women. Compared to unfit men and women, fewer men (Hazard Ratio [HR]: 0.34, 95 % Confidence Interval [CI] 0.15-0.78) and women (HR: 0.41, 95 % CI 0.17-0.98) classified as moderately fit encountered Death with no additional risk reduction among those classified as being more fit. It appears to be easier for the Grim Reaper to claim those in poorer physical condition, specifically VO_2peak levels <26.5 mL/kg/min for men and 22.2 mL/kg/min for women (corresponding to ≥85 % of the observed age- and sex-specific average).

Conclusion: The Grim Reaper typically targets individuals with VO_2peak levels <26.5 mL/kg/min/ and <22.2 mL/kg/min when chasing male and female souls aged 70-77 years, respectively, reflecting his penchant for limited CRF. These data underscore the importance of maintaining or enhancing CRF throughout life, providing clear targets for clinicians in assessing patient CRF levels.

Trial registration: ClinicalTrials.govNCT01666340.

Keywords: All cause-mortality; Clinical cardiorespiratory fitness targets; Generation 100; Grim Reaper; Objectively measured VO(2peak); Older men and women.

Associated data

ClinicalTrials.gov/NCT01666340