Willis BL, et al. - Researchers investigated if there is an inverse relationship of fitness measured in midlife with later-life cardiovascular disease (CVD) mortality with preceding depression. They found that midlife fitness was related to a lower risk of later-life depression, CVD mortality, and CVD mortality after incident later-life depression. These data should encourage physicians to consider fitness and physical activity in promoting healthy aging.

Methods

• As part of the Cooper Center Longitudinal Study, researchers performed this retrospective cohort study at a single-center, community-based preventive medicine clinic.
• Data collection lasted from January 13, 1971 through December 31, 2009 and data analysis from October 6, 2015 through August 14, 2017.
• Generally healthy men and women who presented for preventive medicine examinations at midlife and who were eligible for Medicare from 1999 to 2010 were included, and those with a self-reported history of depression, myocardial infarction, or stroke at examination were excluded.
• Results of treadmill exercise testing were assessed to estimate objective midlife fitness.
• They assessed depression diagnosis from Medicare claims files using established algorithms and CVD mortality from National Death Index records.

Results

• This study included 17,989 participants (80.2% men) with a mean (SD) age of 50.0 (8.7) years.
• Data reported 2,701 depression diagnoses, 610 deaths due to CVD without prior depression, and 231 deaths due to CVD after depression after 117,218 person-years of Medicare follow-up.
• A high level of fitness in midlife vs a low level of fitness was found to be related to a 16% lower risk of depression (hazard ratio [HR], 0.84; 95% CI, 0.74-0.95).
• A high fitness level vs a low level of fitness was also found to be related to a 61% lower risk of death due to CVD without depression (HR, 0.39; 95% CI, 0.31-0.48).
• Findings revealed a high fitness level vs a low fitness level was associated with a 56% lower risk of death due to CVD (HR, 0.44; 95% CI, 0.31-0.64), after a diagnosis of depression.